Saint Joseph Saint Luc Hospital

Saint-Joseph-de-Rivière, France

Saint Joseph Saint Luc Hospital

Saint-Joseph-de-Rivière, France

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Yayehd K.,University of Lomé | Ngda N.W.,University of Lomé | Belle L.,Annecy Hospital | Bataille V.,Toulouse University Hospital Center | And 21 more authors.
Archives of Cardiovascular Diseases | Year: 2016

Background. - Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a suddentemporary weakening of the heart. TTC can mimic acute myocardial infarction and is associatedwith a minimal release of myocardial biomarkers in the absence of obstructive coronary arterydisease.Aims. - To provide an extensive description of patients admitted to hospital for TTC throughoutFrance and to study the management and outcomes of these patients.Methods. - In 14 non-academic hospitals, we collected clinical, electrocardiographic, biolog-ical, psychological and therapeutic data in patients with a diagnosis of TTC according to theMayo Clinic criteria.Results. - Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and theprevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%,obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea(24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment ele-vation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads weremost frequently associated with ST-segment elevation, whereas T-wave inversion was morecommonly associated with lateral leads, and Q-waves with septal leads. The ratio of peakB-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak tro-ponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up,3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehos-pitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due tonon-cardiovascular causes. There was no recurrence of TTC.Conclusions. - This observational study of TTC included primarily women with atheroscleroticrisk factors and mental stress. T-wave inversion was more common than ST-segment elevation.There were few adverse cardiovascular outcomes in these patients after 1-year follow-up. © 2015 Elsevier Masson SAS. All rights reserved.


Couraud S.,Lyon Sud Hospital | Couraud S.,University of Lyon | Couraud S.,Lady Davis Institute for Medical Research | Couraud S.,McGill University | And 24 more authors.
European Respiratory Journal | Year: 2015

Lung cancer in never-smokers (LCINS) (fewer than 100 cigarettes in lifetime) is considered as a distinct entity and harbours an original molecular profile. However, the epidemiological and molecular features of LCINS in Europe remain poorly understood. All consecutive newly diagnosed LCINS patients were included in this prospective observational study by 75 participating centres during a 14-month period. Each patient completed a detailed questionnaire about risk factor exposure. Biomarker and pathological analyses were also collected. We report the main descriptive overall results with a focus on sex differences. 384 patients were included: 65 men and 319 women. 66% had been exposed to passive smoking (significantly higher among women). Definite exposure to main occupational carcinogens was significantly higher in men (35% versus 8% in women). A targetable molecular alteration was found in 73% of patients (without any significant sex difference): EGFR in 51%, ALK in 8%, KRAS in 6%, HER2 in 3%, BRAF in 3%, PI3KCA in less than 1%, and multiple in 2%. We present the largest and most comprehensive LCINS analysis in a European population. Physicians should track occupational exposure in men (35%), and a somatic molecular alteration in both sexes (73%). Copyright © ERS 2015.


PubMed | Institute mutualiste Montsouris, Haguenau Hospital, Georges Pompidou University Hospital, Versailles Hospital and 16 more.
Type: Journal Article | Journal: Archives of cardiovascular diseases | Year: 2016

Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a sudden temporary weakening of the heart. TTC can mimic acute myocardial infarction and is associated with a minimal release of myocardial biomarkers in the absence of obstructive coronary artery disease.To provide an extensive description of patients admitted to hospital for TTC throughout France and to study the management and outcomes of these patients.In 14 non-academic hospitals, we collected clinical, electrocardiographic, biological, psychological and therapeutic data in patients with a diagnosis of TTC according to the Mayo Clinic criteria.Of 117 patients, 91.5% were women, mean SD age was 71.4 12.1 years and the prevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%, obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea (24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment elevation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads were most frequently associated with ST-segment elevation, whereas T-wave inversion was more commonly associated with lateral leads, and Q-waves with septal leads. The ratio of peak B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak troponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up, 3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehospitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due to non-cardiovascular causes. There was no recurrence of TTC.This observational study of TTC included primarily women with atherosclerotic risk factors and mental stress. T-wave inversion was more common than ST-segment elevation. There were few adverse cardiovascular outcomes in these patients after 1-year follow-up.


PubMed | Lady Davis Institute for Medical Research, Georges Francois Leclerc Cancer Center, University of Lyon, University of Paris Pantheon Sorbonne and 15 more.
Type: Journal Article | Journal: The European respiratory journal | Year: 2015

Lung cancer in never-smokers (LCINS) (fewer than 100 cigarettes in lifetime) is considered as a distinct entity and harbours an original molecular profile. However, the epidemiological and molecular features of LCINS in Europe remain poorly understood. All consecutive newly diagnosed LCINS patients were included in this prospective observational study by 75 participating centres during a 14-month period. Each patient completed a detailed questionnaire about risk factor exposure. Biomarker and pathological analyses were also collected. We report the main descriptive overall results with a focus on sex differences. 384 patients were included: 65 men and 319 women. 66% had been exposed to passive smoking (significantly higher among women). Definite exposure to main occupational carcinogens was significantly higher in men (35% versus 8% in women). A targetable molecular alteration was found in 73% of patients (without any significant sex difference): EGFR in 51%, ALK in 8%, KRAS in 6%, HER2 in 3%, BRAF in 3%, PI3KCA in less than 1%, and multiple in 2%. We present the largest and most comprehensive LCINS analysis in a European population. Physicians should track occupational exposure in men (35%), and a somatic molecular alteration in both sexes (73%).


Couraud S.,University of Lyon | Vaca-Paniagua F.,International Agency for Research on Cancer | Villar S.,International Agency for Research on Cancer | Oliver J.,International Agency for Research on Cancer | And 20 more authors.
Clinical cancer research : an official journal of the American Association for Cancer Research | Year: 2014

PURPOSE: Tumor somatic mutation analysis is part of the standard management of metastatic lung cancer. However, physicians often have to deal with small biopsies and consequently with challenging mutation testing. Circulating free DNA (cfDNA) is a promising tool for accessing the tumor genome as a liquid biopsy. Here, we evaluated next-generation sequencing (NGS) on cfDNA samples obtained from a consecutive series of patients for the screening of a range of clinically relevant mutations.EXPERIMENTAL DESIGN: A total of 107 plasma samples were collected from the BioCAST/IFCT-1002 lung cancer study (never-smokers cohort). Matched tumor DNA (tDNA) was obtained for 68 cases. Multiplex PCR-based assays were designed to target specific coding regions in EGFR, KRAS, BRAF, ERBB2, and PI3KCA genes, and amplicon sequencing was performed at deep coverage on the cfDNA/tDNA pairs using the NGS IonTorrent Personal Genome Machine Platform.RESULTS: CfDNA concentration in plasma was significantly associated with both stage and number of metastatic sites. In tDNA, 50 mutations (36 EGFR, 5 ERBB2, 4 KRAS, 3 BRAF, and 2 PIK3CA) were identified, of which 26 were detected in cfDNA. Sensitivity of the test was 58% (95% confidence interval, 43%-71%) and the estimated specificity was 87% (62%-96%).CONCLUSION: These data demonstrate the feasibility and potential utility of mutation screening in cfDNA using IonTorrent NGS for the detection of a range of tumor biomarkers in patients with metastatic lung cancer. ©2014 American Association for Cancer Research.


PubMed | Lady Davis Institute for Medical Research, Montelimar Hospital, University of Lyon, University of Paris Pantheon Sorbonne and 12 more.
Type: Journal Article | Journal: Clinical cancer research : an official journal of the American Association for Cancer Research | Year: 2014

Tumor somatic mutation analysis is part of the standard management of metastatic lung cancer. However, physicians often have to deal with small biopsies and consequently with challenging mutation testing. Circulating free DNA (cfDNA) is a promising tool for accessing the tumor genome as a liquid biopsy. Here, we evaluated next-generation sequencing (NGS) on cfDNA samples obtained from a consecutive series of patients for the screening of a range of clinically relevant mutations.A total of 107 plasma samples were collected from the BioCAST/IFCT-1002 lung cancer study (never-smokers cohort). Matched tumor DNA (tDNA) was obtained for 68 cases. Multiplex PCR-based assays were designed to target specific coding regions in EGFR, KRAS, BRAF, ERBB2, and PI3KCA genes, and amplicon sequencing was performed at deep coverage on the cfDNA/tDNA pairs using the NGS IonTorrent Personal Genome Machine Platform.CfDNA concentration in plasma was significantly associated with both stage and number of metastatic sites. In tDNA, 50 mutations (36 EGFR, 5 ERBB2, 4 KRAS, 3 BRAF, and 2 PIK3CA) were identified, of which 26 were detected in cfDNA. Sensitivity of the test was 58% (95% confidence interval, 43%-71%) and the estimated specificity was 87% (62%-96%).These data demonstrate the feasibility and potential utility of mutation screening in cfDNA using IonTorrent NGS for the detection of a range of tumor biomarkers in patients with metastatic lung cancer.

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