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To evaluate the evidence for quality of life (QoL) impairment, disability, healthcare resource use and economic burden associated with chronic daily headache (CDH), focusing on chronic migraine (CM) with or without medication overuse. A systematic review and qualitative synthesis of studies of patients/subjects with CDH that included CM, occurring on at least 15 days per month. Thirty-four studies were included for review (25 studies of patients and nine of subjects from the general population). CDH and CDH with medication overuse headache (MOH) were consistently associated with a lower QoL compared to control or episodic headache (EH) and CDH without MOH. CDH was consistently associated with greater disability and productivity loss, more consultations, more or longer hospitalizations and higher direct costs than EH. Data were not amenable to statistical pooling. The findings of this review underline the detriment to QoL and the disabling nature of CDH, and in particular CM and CDH with MOH, and negative impact on workplace productivity compared to other types of headache.


Piche T.,Nice University Hospital Center
Neurogastroenterology and Motility | Year: 2014

In this issue of Neurogastroenterology and Motility, Dr Ewa Wilcz-Villega and colleagues report low expression of E-cadherin, a tight junction protein involved in the regulation of paracellular permeability, in the colonic mucosa of patients with the irritable bowel syndrome (IBS) with predominance of diarrhea (IBS-D) or alternating symptoms (IBS-A). These findings constitute an improvement in our knowledge of epithelial barrier disruption associated with IBS. There is mounting evidence to indicate that a compromised epithelial barrier is associated with low-grade immune activation and intestinal dysfunction in at least a proportion of IBS patients. During the last 10 years of research, much interest has focused on the increase in the number of different types of immune cells in the gut mucosa of IBS patients including: mast cells, T lymphocytes, and other local cells such as enteroendocrine cells. The inflammatory mediators released by these cells or other luminal factors could be at the origin of altered epithelial barrier functions and enteric nervous system signaling, which lead to gut hypersensitivity. A current conceptual framework states that clinical symptoms of IBS could be associated with structural and functional abnormalities of the mucosal barrier, highlighting the crucial importance of elucidating the contributory role of epithelial barrier defects in the pathogenesis of IBS. More importantly, disruption of the epithelial barrier could also participate in the generation of persistent abdominal pain and discomfort mimicking IBS in patients with inflammatory bowel diseases considered in remission. This mini review gives a brief summary of clinical and experimental evidence concerning the mechanisms underlying epithelial barrier defects in IBS. © 2014 John Wiley & Sons Ltd.


Lanteri-Minet M.,Nice University Hospital Center
Current Pain and Headache Reports | Year: 2014

Chronic migraine (CM) is a subtype of migraine broadly defined by the presence of headache at least 15 days per month. Emerging evidence suggests that CM and episodic migraine (EM) differ not only in headache frequency, but that they are distinct clinical entities. Because individuals with CM are more disabled, they demonstrate higher societal burden than those with EM. There have been three important surveys published within the last five years that have focused on the societal burden associated with CM. The first is the American Migraine Prevalence and Prevention (AMPP) study, a longitudinal population-based survey performed in the U.S. The second, the International Burden Migraine Study (IBMS), is a Web-based survey conducted in North America, Western Europe, Asia/Pacific, and Brazil. The third is a clinic-based survey performed in Taiwan. This review discusses results of these studies with regard to healthcare resource use (and related direct costs) and loss of productivity (and related indirect costs) from the perspective of cost-effectiveness of new therapeutic approaches to CM. © Springer Science+Business Media 2013.


Lanteri-Minet M.,Nice University Hospital Center
Headache | Year: 2014

Background Hypnic headache (HH) is a rare primary headache characterized by strictly sleep-related headache attacks. Methods This paper reviews the pertinent literature on HH. Results Disease information is mainly based on case reports and small case series (around 250 cases) published since its first description in 1988 by Raskin. HH usually starts over the age of 50. Frequency of patients with HH among patients consulting tertiary headache care centers is estimated from 0.07% to 0.35%, but exact prevalence of HH is unknown. Diagnostic criteria were recently updated by the third edition of the International Classification of Headache Disorders beta version (ICHD-3). Recent data suggest a possible hypothalamic involvement. Conclusion Development of clinical research is needed to better understand the mechanisms of HH and to optimize treatment. Evidence for treatment data are missing, so treatment recommendations are based only on case reports or smaller open case series and reflect clinical experience. Caffeine can be used first line for acute treatment. Lithium and caffeine are possibly effective in prevention. © 2014 American Headache Society.


Grant
Agency: European Commission | Branch: FP7 | Program: CP | Phase: ICT-2011.5.1 | Award Amount: 10.63M | Year: 2011

The increase in average lifespan across the world has been accompanied by an unprecedented upsurge in the occurrence of dementia with high socio-economic costs. The development of personal health systems provides a means of dealing with such problems in a meaningful and sustainable manner, enabling persons with dementia to maintain independence and inclusion in society, while improving their quality of life and the effectiveness of their caregivers. Multi-parametric monitoring of daily activities, lifestyle, behaviour, in combination with medical data, provides clinicians a comprehensive image of the persons condition and its progression, without their being physically present, allowing remote care of their condition. The objective of Dem@Care is the development of a complete system providing personal health services to people with dementia, as well as medical professionals and caregivers, by using a multitude of sensors, for context-aware, multi-parametric monitoring of lifestyle, ambient environment, and health parameters. Multi-sensor data analysis, combined with intelligent decision making mechanisms, will allow an accurate representation of the persons current status and will provide the appropriate feedback, both to the person and the associated caregivers, enhancing the standard clinical workflow. Many research challenges will arise, ranging from data collection and analysis to integration, interpretation and feedback. Aggregation of information from complementary sources will be a critical aspect of multi-sensor processing that will be addressed, along with the advance of knowledge and data management methodologies, for scalable and meaningful interpretation of the persons condition. The data will be analysed and interpreted in conjunction with established or newly created medical knowledge, for the production of shared patient-doctor decision support systems. Appropriate user-friendly interfaces will be developed, facilitating the rapid incorporation of the proposed system in the users lives.


Grant
Agency: European Commission | Branch: FP7 | Program: CP | Phase: ICT-2011.5.5 | Award Amount: 6.19M | Year: 2011

Social exclusion has many causes, but major factors are the fear and apathy that often accompany a disability. The European e-Inclusion policy stresses the importance of ICT in improving the quality of life in potentially disadvantaged groups, including older people and persons with disabilities. In this project, we will develop ICT tools to support the treatment of people who are at risk of social exclusion due to fear and/or apathy associated with a disability. These tools will be in the form of personalised VR scenarios and serious games specifically designed for therapeutic targets and made broadly available via a novel integration of interactive 3D environments directly into Web browsers. We will perform cutting edge research into rendering and simulating personalised and populated VR environments, 3D web graphics, and serious games. These technical efforts will be underpinned by our clinical/laboratory and industry partners, who will be fully involved throughout in the requirements, design and evaluation of VERVE, and liaison with the stakeholders (i.e., participants, carers/family, and health professionals). They will implement the VERVE interventions in three use-cases, each targeting a different group of participants: Fear of falling, Apathy related to cognitive decline and behavioural disturbances, and other emotional disturbances linked to anxiety. While developing clinical assessment methods and interventions for the first two patient groups is our primary focus, our results will be applicable to a much wider range of potentially disadvantaged individuals.


Patent
French National Center for Scientific Research and Nice University Hospital Center | Date: 2016-01-27

The present invention relates to the protein THSD7A (Thrombospondin, Type I, Domain Containing 7A) as a biomarker autoantigen in membranous nephropathy, particularly idiopathic membranous nephropathy. The invention provides diagnostic, prognostic and monitoring methods for membranous nephropathy in a patient based on the detection of autoantibodies recognizing the THSD7A protein (anti-THSD7A autoantibodies) and associated kits. The invention also provides diagnostic methods and kits based on the detection of the THSD7A level. The invention further provides therapeutic methods for membranous nephropathy.


Boquet P.,Nice University Hospital Center | Ricci V.,University of Pavia
Trends in Microbiology | Year: 2012

VacA toxin from the cancer-inducing bacterium Helicobacter pylori is currently classified as a pore-forming toxin but is also considered a multifunctional toxin, apparently causing many pleiotropic cell effects. However, an increasing body of evidence suggests that VacA could be the prototype of a new class of monofunctional A-B toxins in which the A subunit exhibits pore-forming instead of enzymatic activity. Thus, VacA may use a peculiar mechanism of action, allowing it to intoxicate the human stomach. By combining the action of a cell-binding domain, a specific intracellular trafficking pathway and a novel mitochondrion-targeting sequence, the VacA pore-forming domain is selectively delivered to the inner mitochondrial membrane to efficiently kill target epithelial cells by apoptosis. © 2012 Elsevier Ltd.


Grant
Agency: European Commission | Branch: H2020 | Program: RIA | Phase: PHC-22-2015 | Award Amount: 6.87M | Year: 2016

Mental, cognitive, vision and hearing health problems in elderly people are amongst the top 10 public health challenges in Europe. They frequently occur co-concurrently and have an additive negative effect on quality of life and mental well-being. To address this negative impact, and promote mental well-being, particularly from a gender and minority community perspective, SENSE-Cogs aim is to: (1) understand the inter-relationship of sensory impairments and cognitive and mental health functioning; (2) identify novel means of screening/detection for diagnostic and therapeutic purposes; and (3) translate this knowledge into clinical applications for the mental well-being of EU citizens. Methods: SENSE-Cog will use a mixed methods approach with a trans-EU, UK-led, multidisciplinary collaboration of 7 EU countries with academics, SMEs, city government and patient-public voice members. We will deliver linked Work Packages (WPs) reflecting 7 themes: (1) exploration: an epidemiological analysis of 5 large EU longitudinal databases to detect risk profiles for good and poor mental health outcomes; (2) assessment: the adaptation/validation of assessment tools for cognition and sensory impairment for vulnerable populations, including the development of a composite e-screen for sensory, cognitive and mental functioning; (3) intervention: a clinical trial of a newly developed sensory support intervention; (4) participation: an EU patient and public voice and innovative public engagement network to inform the WPs and communicate findings; (5) valuation: health economic and cost effectiveness analyses; & (6) management, governance/ethics. Impact: SENSE-Cog will promote earlier detection of sensory, cognitive and mental impairments to enable swift interventions, prevent deterioration and limit negative impacts.


Grant
Agency: European Commission | Branch: FP7 | Program: CP | Phase: SPA.2009.1.1.01 | Award Amount: 7.17M | Year: 2010

Air quality is a crucial environmental factor, e.g. evidenced by the fact that particles in the air are estimated to reduce the lifetime of the average European citizen by 8 months. Assessing and monitoring air quality are thus fundamental to improve Europes welfare. PASODOBLE will develop and demonstrate user-driven downstream information services for the public, regional and local air quality sectors by combining space-based and in-situ data with models in 4 thematic service lines: (1) Health community support for hospitals, pharmacies, doctors and people at risk, (2) public information for regions, cities, tourist industry and sporting event organizers, (3) compliance monitoring support on particulate matter for regional environmental agencies and (4) local forecast model evaluation support for local authorities and city bodies. Continuing on the achievements of the ESA GSE PROMOTE project, PASODOBLE will stimulate the development of quality-assured air quality services towards their application market by increasing the implementation efficiency of demonstrated and operational services in the future (new regions, users or parameter combinations, additional service providers). PASODOBLE objectives are: (1) evolution of existing and development of new sustainable air quality services for Europe on regional and local scales, (2) development and testing of a generic service framework for coordinated input data acquisition and customizable user-friendly access to services, (3) utilization of multiple cycles of delivery, use and assessment versus requirements and market planning in cooperation with users and (4) promotion and harmonisation of best practise tools for air quality communities. PASODOBLE comprises an initial phase of requirement analysis, service design, development and implementation, followed by 2 annual demonstration and evaluation cycles in which the services and the generic framework with regard to user needs and business planning will be assessed.

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