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Saint-Pierre-du-Chemin, France

de Souto Barreto P.,Toulouse University Hospital Center | de Souto Barreto P.,Aix - Marseille University | de Souto Barreto P.,University Paul Sabatier | Demougeot L.,Toulouse University Hospital Center | And 5 more authors.
Ageing Research Reviews | Year: 2015

This systematic review and meta-analysis of randomized controlled trials assessed the effects of exercise on behavioral and psychological symptoms of dementia (BPSD, including depression) in people with dementia (PWD). Secondary outcomes for the effects of exercise were mortality and antipsychotic use. Twenty studies were included in this review (n = 18 in the meta-analysis). Most studies used a multicomponent exercise training (n = 13) as intervention; the control group was often a usual care (n = 10) or a socially-active (n = 8) group. Exercise did not reduce global levels of BPSD (n = 4. Weighted mean difference -3.884; 95% CI -8.969-1.201; I2 = 69.4%). Exercise significantly reduced depression levels in PWD (n = 7). Standardized mean difference -0.306; 95% CI -0.571 to -0.041; I2 = 46.8%); similar patterns were obtained in sensitivity analysis performed among studies with: institutionalized people (p = 0.038), multicomponent training (p = 0.056), social control group (p = 0.08), and low risk of attrition bias (p = 0.11). Exploratory analysis showed that the principal BPSD (other than depression) positively affected by exercise was aberrant motor behavior. Exercise had no effect on mortality. Data on antipsychotics were scarce. In conclusion, exercise reduces depression levels in PWD. Future studies should examine whether exercise reduces the use (and doses) of antipsychotics and other drugs often used to manage BPSD. © 2015 Elsevier B.V. Source


Thomas P.A.,Aix - Marseille University | Berbis J.,Aix - Marseille University | Pimpec-Barthes F.L.,HEGP | Tronc F.,Louis Pradel Hospital | And 3 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2015

Objective: The study objective was to determine contemporary early outcomes associated with pneumonectomy for lung cancer and to identify their predictors using a nationally representative general thoracic surgery database (EPITHOR). Methods: After discarding inconsistent files, a group of 4498 patients who underwent elective pneumonectomy for primary lung cancer between 2003 and 2013 was selected. Logistic regression analysis was performed on variables for mortality and major adverse events. Then, a propensity score analysis was adjusted for imbalances in baseline characteristics between patients with or without neoadjuvant treatment. Results: Operative mortality was 7.8%. Surgical, cardiovascular, pulmonary, and infectious complications rates were 14.9%, 14.1%, 11.5%, and 2.7%, respectively. None of these complications were predicted by the performance of a neoadjuvant therapy. Operative mortality analysis, adjusted for the propensity scores, identified age greater than 65 years (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5-2.9; P<.001), underweight body mass index category (OR, 2.2; 95% CI, 1.2-4.0; P = .009), American Society of Anesthesiologists score of 3 or greater (OR, 2.310; 95% CI, 1.615-3.304; P<.001), right laterality of the procedure (OR, 1.8; 95% CI, 1.1-2.4; P = .011), performance of an extended pneumonectomy (OR, 1.5; 95% CI, 1.1-2.1; P = .018), and absence of systematic lymphadenectomy (OR, 2.9; 95% CI, 1.1-7.8; P = .027) as risk predictors. Induction therapy (OR, 0.63; 95% CI, 0.5-0.9; P = .005) and overweight body mass index category (OR, 0.60; 95% CI, 0.4-0.9; P = .033) were protective factors. Conclusions: Several risk factors for major adverse early outcomes after pneumonectomy for cancer were identified. Overweight patients and those who received induction therapy had paradoxically lower adjusted risks of mortality. Copyright © 2015 by The American Association for Thoracic Surgery. Source


Meyer N.,University Paul Sabatier | Paul C.,Larrey Hospital | Paul C.,University Paul Sabatier | Joly P.,University of Rouen
Dermatologic Clinics | Year: 2011

Limited data are available on the epidemiology of autoimmune bullous diseases in France and in Western Europe. Bullous pemphigoid represents the most common autoimmune bullous disease. The management of autoimmune bullous diseases in France is under the guidance of dermatologists. In 1985, a research group focused on autoimmune bullous diseases was created in France. In 2004, the French Ministry of Health established and funded a nationwide network including 2 references centers, 7 competence centers, and 30 corresponding centers, with the aim of improving quality of care and research for autoimmune bullous diseases. © 2011 Elsevier Inc. Source


Serrano E.,Ear | Wahn H.U.,Charite Virchow Klinikum | Didier A.,Larrey Hospital | Bachert C.,Ghent University
American Journal of Rhinology and Allergy | Year: 2014

Background: 300IR 5-grass pollen sublingual immunotherapy tablets have been approved for the treatment of allergic rhinitis (AR) with or without conjunctivitis in adults and children >5 years with grass pollen allergy. This study was designed to review data on nasal symptoms with 300IR 5-grass pollen sublingual tablets in adults and children. Methods: We reviewed data from four double-blind, placebo-controlled, randomized clinical trials. Two groups of patients who received a daily dose of either placebo or 300IR 5-grass pollen sublingual tablets starting 4 months before the expected start of the pollen season and continuing through the season were compared (analysis of covariance) for scores of sneezing, rhinorrhea, nasal pruritus, nasal congestion, total nasal symptom score (TNSS), and adult Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores. Results: Data for 266 children (one pediatric trial) and 1036 adults (three trials) were analyzed. Compared with the placebo groups, mean TNSS in the 300IR groups was lower by 22% in children and 19-36% in adults. Among the four nasal symptoms, the lowest scores relative to placebo were for nasal congestion in children (31%) and adults (43%). Mean adult RQLQ scores were 21-31% lower in the 300IR group than in the placebo group. Conclusion: Allergen immunotherapy with 300IR 5-grass pollen sublingual tablets was consistently associated with AR symptom relief in adults and children and provided a clinically meaningful improvement in quality of life. Copyright © 2014, OceanSide Publications, Inc., U.S.A. Source


Didier A.,Larrey Hospital | Campo P.,University of Malaga | Moreno F.,Dr. Lobaton Clinic | Durand-Perdriel F.,Private Practice | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2016

Background: House dust mite (HDM) immunotherapy has proven efficacy in treating allergic rhinitis (AR) symptoms. This trial evaluated the dose-response relationship of SLIToneULTRA® HDM mix based on immunological parameters and safety in subjects with moderate-to-severe HDM AR not controlled by symptomatic medication. Materials and Methods: A randomized, parallel-group, open-label, clinical trial compared 50/150/300 standard reactivity unit (SRU) doses of SLIToneULTRA® HDM mix for 6 months. Subjects had moderate-to-severe HDM AR, positive skin prick and IgE against Dermatophagoides pteronyssinus/Dermatophagoides farinae (DP/DF). The primary end point was change from baseline in the IgE-blocking factor against DP after 6 months. Secondary end points measured changes in the IgE-blocking factor for DP at 3 months and for DF at 3 and 6 months, and in IgG4 and specific IgE to DP/DF after 3 and 6 months. Tolerability was assessed through the evaluation of all adverse events (AEs). Results: A total of 219 subjects were randomized and 196 completed the trial. Dose effect was significant on DP IgE-BF after 6 months (p = 0.018). The change in the DP IgE-blocking factor at a 300-SRU dose was higher than at other doses after 3 (p = 0.008) and 6 (p = 0005) months of treatment. Similar changes were observed for IgG4 and allergen-specific IgE. The number of AEs increased with the dose and were mild-to-moderate, with no severe treatment-related AEs reported. The most frequent AEs were oral/tongue pruritus, mouth oedema and abdominal upper pain. Conclusions: Data showed a dose-response for immunological markers and safety with a better immunological response for 300 SRU. The highest dose (300 SRU daily) was considered as the optimal maintenance dose. © 2016 The Author(s) Published by S. Karger AG, Basel. Source

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