Laennec Hospital

Quimper, France

Laennec Hospital

Quimper, France

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Guillemin F.,University of Lorraine | Guillemin F.,University of Sfax | Guillemin F.,French Institute of Health and Medical Research | Rat A.C.,University of Lorraine | And 19 more authors.
Osteoarthritis and Cartilage | Year: 2011

Objective: Osteoarthritis (OA) epidemiologic data are scarce in Europe. To estimate the prevalence of symptomatic knee and hip OA in a multiregional sample in France. Design: A two-phase population-based survey was conducted in six regions in 2007-2009. On initial phone contact using random-digit dialing, subjects 40-75 years old were screened with a validated questionnaire. Subjects screened positive were invited for ascertainment: physical examination and hip and/or knee radiography (Kellgren-Lawrence grade ≥ 2). Multiple imputation for data missing not-at-random was used to account for refusals. Results: Of 63,232 homes contacted, 27,632 were eligible, 9621 subjects screened positive, 3707 participated fully in the ascertainment phase, and 1010 had symptomatic OA: 317 hip, 756 knee. Hip OA prevalence according to age class ranged from 0.9% to 3.9% for men and 0.7-5.1% for women. Knee OA ranged from 2.1% to 10.1% for men and 1.6-14.9% for women. Both differed by geographical region. The hip and knee standardized prevalence was 1.9% and 4.7% for men and 2.5% and 6.6% for women, respectively. Conclusions: This confirmed the feasibility of using a screening questionnaire for eliciting population-based estimates of OA. In France, it increases with age and is greater among women above the age of 50. The geographical disparity of hip and knee OA parallels the distribution of obesity. Study registration ID number 906297 at http://www.clinicaltrials.gov/. © 2011 Osteoarthritis Research Society International.


Zhang Y.,University of Paris Descartes | Zhang Y.,Shanghai JiaoTong University | Safar M.E.,University of Paris Descartes | Iaria P.,Laennec Hospital | And 4 more authors.
American Heart Journal | Year: 2010

Background: Left ventricular diastolic dysfunction (LVDD) was reported as a significant predictor of mortality, mainly in patients with heart failure. However, prospective data are scarce in the hospitalized elderly population. Methods: We studied the association of severe LVDD, defined by conventional echocardiographic parameters, with cardiovascular and all-cause mortality in a population of 331 hospitalized elderly patients with a history of cardiovascular disease (mean age ± SD, 87 ± 7 years). After a mean follow-up of 378 days, 110 deaths occurred. Results: Compared with left ventricular systolic dysfunction (LVSD), subjects with severe diastolic dysfunction had a similar prevalence (12% vs 10%) and similar cardiovascular and all-cause mortality (18% vs 19%, 49% vs 50%). Both cardiovascular and all-cause mortality increased progressively and significantly with increasing number of diagnostic criteria of LVDD (P = .035, P = .013) and reached 48.7% for all-cause mortality when at least 2 criteria were met. In addition to cardiovascular risk factors and LVSD, severe LVDD provided incremental and independent prognostic information of all-cause mortality with increased χ2 value of Cox regression model (48.1 vs 43.5, P = .022). Conclusions: Severe LVDD, diagnosed by conventional echocardiography, has similar prevalence and prognosis as LVSD and provides incremental prognostic value, which highlights the clinical significance of routine evaluation of LVDD in risk assessment strategies of the hospitalized elderly. © 2010 Mosby, Inc. All rights reserved.


Gall E.C.-L.,University Hospital | Gall E.C.-L.,European University of Brittany | Gall E.C.-L.,French Institute of Health and Medical Research | Audrezet M.-P.,University Hospital | And 28 more authors.
Journal of the American Society of Nephrology | Year: 2016

The courseof autosomal dominant polycystic kidney disease (ADPKD)variesamongindividuals,with somereaching ESRD before 40 years of age and others never requiring RRT. In this study, we developed a prognostic model to predict renal outcomes in patients with ADPKD on the basis of genetic and clinical data. We conducted a crosssectional study of 1341 patients from theGenkyst cohort and evaluated the influence of clinical and genetic factors on renal survival. Multivariate survival analysis identified four variables that were significantly associated with age at ESRDonset,andascoringsystemfrom0to9wasdevelopedas follows:beingmale:1 point; hypertensionbefore 35 years of age: 2 points; first urologic event before 35 years of age: 2 points; PKD2 mutation: 0 points; nontruncating PKD1 mutation: 2 points; and truncating PKD1 mutation: 4 points. Three risk categories were subsequently defined as low risk (0-3 points), intermediate risk (4-6 points), and high risk (7-9 points) of progression to ESRD, with correspondingmedian ages for ESRDonset of 70.6, 56.9, and 49 years, respectively. Whereas a score#3 eliminates evolution toESRDbefore60years ofagewith anegative predictive valueof81.4%, a score.6forecastsESRDonset before 60 years of agewith a positive predictive value of 90.9%. This newprognostic score accurately predicts renal outcomes in patients with ADPKD and may enable the personalization of therapeutic management of ADPKD.


Causse X.,Regional Hospital | Cadranel J.-F.,Laennec Hospital | Potier P.,Regional Hospital | Hanslik B.,Millenium Clinic | And 3 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2015

Background: Before the 2012 revision of the EASL guidelines for the management of hepatitis B virus infection, we conducted a survey to determine how French nonacademic hepatogastroenterologists defined inactive hepatitis B virus carriers and immunotolerant patients. Methods: We asked 680 hepatogastroenterologists to complete a simple survey consisting of 11 multiple-choice questions. Results: The participation rate was 32%. HBeAg positivity was not identified as a key criterion for the diagnosis of immunotolerance by 61.9% of the respondents. A total of 82.5 and 75.9% of the respondents identified repeatedly normal alanine transaminase levels and repeatedly low viremia (<2000 IU/ml), respectively, as relevant criteria for the HBsAg inactive carrier state. The question on the biological monitoring of inactive carriers and immunotolerant patients was answered by 78% of the respondents, 97% of whom considered determinations of α-fetoprotein concentration and viremia every 6 (n=58, 35%) or 12 months (n=105, 63%) to be useful. Overall, 19% of the respondents declared never having treated an immunotolerant patient; 81% reported that they had treated such patients under some circumstances: 73% before immunosuppression or chemotherapy, 54% treated pregnant women in their third trimester when viremia was greater than 7 log IU/ml, 49% treated health professionals to prevent contamination, and 31% before medically assisted procreation. Conclusion: The definition of 'inactive carrier state' seems to have been well assimilated, but immunotolerance remains poorly understood. Biological monitoring was frequently carried out for inactive carriers and immunotolerant patients, but the diversity of the responses obtained highlights the lack of clear recommendations for the follow-up of these populations. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Morvan J.,Laennec Hospital | Bouttier R.,Brest University Hospital Center | Mazieres B.,Toulouse University Hospital Center | Mazieres B.,University Paul Sabatier | And 15 more authors.
Journal of Rheumatology | Year: 2013

Objective. The relationship between acetabular dysplasia (HD) and hip osteoarthritis (OA) remains unclear, especially for mild forms of dysplasia. Our objectives were to estimate the prevalence of HD in a population-based sample with symptoms and to evaluate potential associations linking HD, hip OA, and hip pain. Methods. Individuals 40 to 75 years of age with symptoms in 1 or both hips were recruited during a multiregional prevalence survey. All study participants underwent examination and radiographs. Radiographs were evaluated using Kellgren-Lawrence staging (with stages ≥ 2 indicating hip OA) and HD measures [center-edge (CE) angle, acetabular inclination angle (HTE), acetabular depth (AD), and vertical center-anterior margin angle]. Results. We studied both hips of 842 individuals (1684 hips), among whom 203 had hip OA. Compared to left hips, right hips had significantly smaller CE angles and significantly greater AD and HTE values (p ≤ 0.001). Overall, the prevalence of HD ranged from 7.6% to 22.2% of the hips depending on the measure used. The prevalence of HD was higher in individuals with hip OA, with significant differences for abnormal HTE (19.1% vs 11.4%; p < 0.0001) and abnormal CE (11.3% vs 7.5%; p = 0.04). By logistic regression, only abnormal HTE remained associated with OA. Same-side hip pain was not statistically more common in individuals with HD after stratification on OA status (p = 0.12). Conclusion. Our study confirms the relationship between OA and HD, particularly as defined based on the HTE angle. The Journal of Rheumatology Copyright © 2013. All rights reserved.


Bigot E.,Laennec Hospital | Bataille R.,Anti Cancer Center Rene Gauducheau | Patrice T.,Laennec Hospital
Journal of Photochemistry and Photobiology B: Biology | Year: 2012

Photodynamic therapy (PDT) generates singlet oxygen ( 1O 2) and Reactive Oxygen Species (ROS) that are counteracted by patient's defenses. As cancer treatments are among the most important PDT applications the aim of this pilot study was to determine whether the serum of cancer patients produces more or less secondary ROS or peroxides after a photoreaction as compared to healthy persons. Fifty-three volunteers and 105 cancer patients were recruited. The capacity of 1O 2 or secondary oxidant production was found to be increased in 6 healthy donors and 36 cancer patients (23/69 women and 13/31 men p < 0.007 and p < 0.04) with a mean value of 1.52 as compared to 1.29 in the healthy subjects (p < 0.05) when considering values higher than the normal range (norm = 1 ± 10%) or 1.1 vs. 0.85 (p < 0.01) in the whole cohort. This increase correlated with a poor prognosis, TNM and SBR classification. Serum 1O 2 deactivation capacity was impaired and secondary ROS were more produced during cancer progression. Although it is currently unclear whether this is the cause or effect of cancer, this finding may hold interest as a potential marker of cancer severity. It would also support the interest of PDT as an adjuvant for cancer treatment, even for aggressive tumors particularly when associated to surgery for bulk removal. © 2011 Elsevier B.V. All rights reserved.


Goutier S.,Grenoble Teaching Hospital | Ferquel E.,Institute Pasteur Paris | Pinel C.,Grenoble Teaching Hospital | Pinel C.,Joseph Fourier University | And 13 more authors.
Emerging Infectious Diseases | Year: 2013

Borrelia crocidurae-associated relapsing fever is endemic to West Africa and is considered benign. We report 4 patients with B. crocidurae-associated neurologic symptoms; 2 of their cases had been misdiagnosed. Frequency and severity of this disease could be underestimated; molecular methods and serodiagnostic tests for Lyme disease might be helpful in its detection.


Guerin P.,Laennec Hospital | Bigot E.,Laennec Hospital | Patrice T.,Laennec Hospital
Journal of Thrombosis and Thrombolysis | Year: 2013

Blood flow arrest and reperfusion during myocardial infarction (MI) cause myocyte and endothelium injury through oxidative stress and inflammation, both of which involve Reactive Oxygen Species (ROS) and peroxides that consume antioxidant defenses. The aim of this study was to determine whether serum from the occluded coronary vessel has impaired anti-oxidative defenses as compared to serum from aortic blood or from the periphery of healthy controls. Forty-seven patients (44 men) were included for study. Inclusion criteria were chest pain, ST elevation, and cardiac troponin increase. A photoreaction producing a standardized amount of singlet oxygen (1O2), an excited form of oxygen, was performed in serum samples obtained during primary percutaneous coronary intervention (PCI). Immediately after laser light delivery to 5 % sera containing 5 μg/mL rose bengal, dichloro-dihydro-fluorescein (DCFH) was added and its post-oxidation transformation into the fluorescent DCF, was recorded. At least 5 h after the start of symptoms, the mean secondary ROS production after 1O2 delivery was increased in coronary sera (p < 0.001), but in aortic blood remained similar to that of healthy controls. The peak troponin value correlated with DCF fluorescence throughout the interval between symptoms onset and PCI. A high fluorescence was associated with a higher risk of MACE. These results show that oxidants secondary to 1O2 are increased in occluded vessels during AMI in parallel to c-troponin, demonstrating that antioxidants are consumed. A O 2 increase during reperfusion would thus extend the damage resulting from IDM necrosis. The effect of conditioning during PCI could be studied using the described method. © 2012 Springer Science+Business Media, LLC.


Lhommeau I.,Laennec Hospital | Douillard S.,Laennec Hospital | Bigot E.,Laennec Hospital | Benoit I.,Laennec Hospital | And 2 more authors.
Metabolism: Clinical and Experimental | Year: 2011

Diabetes mellitus causes endothelial injury through oxidative stress involving reactive oxygen species and peroxides as well as inflammation, both of which consume antioxidant defenses. Singlet oxygen (1O2) is produced by leukocytes during inflammatory and biochemical reactions and deactivated by producing reactive oxygen species and peroxides. To determine whether serum was capable of deactivating 1O2, we triggered a photo reaction in sera from 53 healthy donors and 52 diabetic patients. Immediately after light delivery, dichlorofluorescein was added and then its fluorescence was recorded. The mean capacity of 1O 2 or secondary oxidant deactivation was reduced in patients with diabetes mellitus. Hemolysis reduced deactivation of 1O 2-induced secondary oxidants in both healthy and diabetic patients. Body mass index, age, platelet counts, and blood cell numbers exerted a nonlinear influence. High levels of glycated hemoglobin were associated with an increased deactivation of oxidative species, whereas high-density lipoprotein cholesterol, total cholesterol, and the total cholesterol to high-density lipoprotein cholesterol ratio decreased the serum deactivation capacity. Oral antidiabetics bore no influence on deactivation, which was restored by insulin in women. Deactivation capacity was lower in women, who had half the complications found in men, suggesting that, with more severe diabetes mellitus, protection was maintained against complications. Resistance to 1O2 should be considered during the monitoring of diabetes mellitus. © 2011 Elsevier Inc. All rights reserved.


PubMed | Laennec Hospital
Type: | Journal: Journal of photochemistry and photobiology. B, Biology | Year: 2012

Photodynamic therapy (PDT) generates singlet oxygen ((1)O(2)) and Reactive Oxygen Species (ROS) that are counteracted by patients defenses. As cancer treatments are among the most important PDT applications the aim of this pilot study was to determine whether the serum of cancer patients produces more or less secondary ROS or peroxides after a photoreaction as compared to healthy persons. Fifty-three volunteers and 105 cancer patients were recruited. The capacity of (1)O(2) or secondary oxidant production was found to be increased in 6 healthy donors and 36 cancer patients (23/69 women and 13/31 men p<0.007 and p<0.04) with a mean value of 1.52 as compared to 1.29 in the healthy subjects (p<0.05) when considering values higher than the normal range (norm=110%) or 1.1 vs. 0.85 (p<0.01) in the whole cohort. This increase correlated with a poor prognosis, TNM and SBR classification. Serum (1)O(2) deactivation capacity was impaired and secondary ROS were more produced during cancer progression. Although it is currently unclear whether this is the cause or effect of cancer, this finding may hold interest as a potential marker of cancer severity. It would also support the interest of PDT as an adjuvant for cancer treatment, even for aggressive tumors particularly when associated to surgery for bulk removal.

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