University Hospital Chu ntpied

Clermont-Ferrand, France

University Hospital Chu ntpied

Clermont-Ferrand, France
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Metz L.,University of Auvergne | Thivel D.,University of Auvergne | Peirrera B.,Clermont Ferrand University Hospital | Richard R.,Clermont University | And 6 more authors.
Disability and Rehabilitation | Year: 2017

Objective: The 6-min walking test (6 MWT) is commonly used to assess obese patients’ aerobic fitness, but it has rarely been compared with a direct measurement of maximal aerobic capacities (VO2max or VO2peak) in obese adults. The aim of this study was to investigate the relationship between the distance covered during a 6 MWT with objectively measured VO2peak and to propose a new equation to predict VO2peak from this walking test in obese patients. Methods: One hundred and thirty-seven obese patients (45.6 ± 12.5 years) admitted to our hospital for a multidisciplinary rehabilitation program were enrolled. After assessment of their body composition, the participants were asked to perform a 6 MWT and their maximal aerobic capacities (VO2peak) were measured. Result: There is a significant linear relation between VO2peak and the distance covered during the 6 MWT (p < 0.001; r = 0.349). The determinant of VO2peak was body mass index, waist-to-hip ratio, fat free mass, leading to the follow prediction equation VO2peak such as VO2peak (l/min) = (body mass index ×0.0150065) − (waist-to-hip-ratio × 0.8595088) + (fat-free-mass × 0.0295478) + (6-min walk test ×0.0020672) − 0.5853372. Conclusion: The 6-min walk test is a reliable method to reflect obese women’s aerobic capacities and the distance covered can be used to accurately estimate VO2peak according to our newly proposed equation. Implication for rehabilitationObesity is a worldwide disease and physical capacity evaluation is a key point for rehabilitation.The six minutes’ walk test is commonly used in obese people to assess aerobic fitness.This study proposes a new equation using 6 MWT performance to estimate VO2peak. © 2017 Informa UK Limited, trading as Taylor & Francis Group


Tekath M.,University Hospital Chu ntpied | Dutheil F.,University Hospital Chu ntpied | Dutheil F.,Australian Catholic University | Dutheil F.,University Blaise Pascal | And 7 more authors.
BMJ Open | Year: 2014

Objectives: Radiation delivered during CT is a major concern, especially for individuals undergoing repeated screening. We aimed to compare a new ultra-low-dose algorithm called Veo with the gold standard filtered back projection (FBP) for detecting pulmonary asbestos-related conditions. Setting: University Hospital CHU G. Montpied, Clermont-Ferrand, France Participants: Asbestos-exposed workers were recruited following referral to screening for asbestos-related conditions. Two acquisitions were performed on a 64-slice CT: the gold standard FBP followed by Veo reconstruction. Outcome measures: Two radiologists independently assessed asbestos-related abnormalities, pulmonary nodules, radiation doses and image quality (noise). Results: We included 27 asbestos-exposed workers (63.3±6.5 years with 11.9±9.7 years of asbestos exposure). We observed 297 pleural plaques in 20 participants (74%). All patients (100%) had pulmonary nodules, totalling 167 nodules. Detection rates did not differ for pleural plaques (Veo 87% vs FBP 97%, NS), pleural thickening (100% for both) and pulmonary nodules (80% for both). Interstitial abnormalities were depicted less frequently with Veo than FBP. False negative and false positive did not exceed 2.7%. Compared with FBP, Veo decreased the radiation dose up to 87% (Veo 0.23±0.07 vs FBP 1.83±0.88 mSv, p<0.001). The objective image noise also decreased with Veo as much as 23% and signal-to-noise ratio increased up to 33%. Conclusions: A low-dose CT with Veo reconstruction substantially reduced radiation. Veo compared favourably with FBP in detecting pleural plaques, pleural thickening and pulmonary nodules. These results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions, especially regarding the low prevalence of interstitial abnormalities in this study. Trial registration number: NCT01955018.


Dutheil F.,University Blaise Pascal | Dutheil F.,Australian Catholic University | Dutheil F.,University Hospital Chu ntpied | Dutheil F.,University of Auvergne | And 15 more authors.
International Journal of Cardiology | Year: 2013

Background Opinions differ over the exercise modalities that best limit cardiovascular risk (CVR) resulting from visceral obesity in individuals with metabolic syndrome (MetS). As little is known about the combined effects of resistance and endurance training at high volumes under sound nutritional conditions, we aimed to analyze the impact of various intensities of physical activity on visceral fat and CVR in individuals with MetS. Methods 100 participants, aged 50-70 years, underwent a diet restriction (protein intake 1.2 g/kg/day) with a high exercise volume (15-20 h/week). They were randomized to three training groups: moderate-resistance-moderate-endurance (re), high-resistance-moderate-endurance (Re), or moderate-resistance-high-endurance (rE). A one-year at-home follow-up (M12) commenced with a three-week residential program (Day 0 to Day 21). We measured the change in visceral fat and body composition by DXA, MetS parameters, fitness, the Framingham score and carotid-intima-media-thickness. Results 78 participants completed the program. At D21, visceral fat loss was highest in Re (- 18%, p <.0001) and higher in rE than re (- 12% vs. - 7%, p <.0001). Similarly, from M3, visceral fat decreased more in high-intensity-groups to reach a visceral fat loss of - 21.5% (Re) and - 21.1% (rE) > - 13.0% (re) at M12 (p <.001). CVR, MetS parameters and fitness improved in all groups. Visceral fat loss correlated with changes in MetS parameters. Conclusion Increased intensity in high volume training is efficient in improving visceral fat loss and carotid-intima-media- thickness, and is realistic in community dwelling, moderately obese individuals. High-intensity-resistance training induced a faster visceral fat loss, and thus the potential of resistance training should not be undervalued (ClinicalTrials.gov number: NCT00917917). © 2013 Elsevier Ireland Ltd.


Crendal E.,Australian Catholic University | Crendal E.,University of Avignon | Dutheil F.,Australian Catholic University | Dutheil F.,University Blaise Pascal | And 5 more authors.
BMC Cardiovascular Disorders | Year: 2014

Background: Evaluation of sensitive myocardial mechanics with speckle tracking echocardiography (STE) across the lifespan may reveal early indicators of cardiovascular disease (CVD) risk. Epicardial adipose tissue (EAT) and left ventricular (LV) myocardial dyssynchrony; subclinical risk-factors of CVD, are of particular clinical interest. However, the evolution of EAT and LV-dyssynchrony across the lifespan, and their influence on myocardial dysfunction remains unclear. We aimed to establish a profile of the healthy aging-heart using conventional, tissue-Doppler imaging (TDI) and speckle-tracking echocardiography (STE), while also exploring underlying contributions from EAT and LV-dyssynchrony towards LV myocardial mechanics, independent of blood biology.Methods: Healthy males aged 19-94 years were recruited through University-wide advertisements in Victoria and New-South Wales, Australia. Following strict exclusion criteria, basic clinical and comprehensive echocardiographic profiles (conventional, TDI and STE) were established. LV-dyssynchrony was calculated from the maximum-delay of time-to-peak velocity/strain in the four LV-annulus sites (TDI), and six LV-segments (STE longitudinal and circumferential axes). Epicardial fat diameter was obtained from two-dimensional grey-scale images in the parasternal long-axis. Blood biological measures included glycemia, hsCRP, triglycerides, total cholesterol, high-density and low-density lipoprotein levels.Results: Three groups of 15 were assigned to young (<40 years), middle (40-65 years), and older (>65) aged categories. Five participants were excluded from STE analyses due to inadequate image quality. Decreased longitudinal strain, increased circumferential apical strain and LV twist were age-related. Moreover, independent of blood biology, significant increases were observed across age categories for EAT (young: 2.5 ± 0.9 mm, middle: 3.9 ± 1.0 mm, older 5.7 ± 2.4 mm; p < 0.01), longitudinal STE-dyssynchrony (young: 42 ± 7.7 ms, middle: 58.8 ± 18.9 ms, older 88.6 ± 18.2 ms; p < 0.05), and circumferential-basal STE-dyssynchrony (young: 50.2 ± 20.5 ms, middle: 75.9 ± 20.6 ms, older 97.9 ± 20.2 ms; p < 0.05). These variables collectively explained 37% and 31% (p < 0.01) of longitudinal strain and LV twist, respectively.Conclusions: This study enabled comprehensive profiling of LV mechanics at different stages of aging using sensitive echocardiographic technology. Novel findings included increased epicardial fat, and both longitudinal and circumferential LV-dyssynchrony across the healthy age groups. These factors may be key underlying contributors to myocardial dysfunction during aging, and their recognition may promote an advanced understanding of early signs of cardiovascular disease. © 2014 Crendal et al.; licensee BioMed Central Ltd.


PubMed | Grenoble Graduate School of Business, University Blaise Pascal, BP 73, British Petroleum and 4 more.
Type: | Journal: Psychiatry research | Year: 2016

The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) has been validated in general population samples in many countries. Interest in using this measure in clinical populations is growing, particularly for tertiary prevention and mental health promotion. This paper reports validation of the French WEMWBS in healthy and chronic remitted schizophrenia populations. The French WEMWBS was administered to 319 workers, 75 students and 121 patients. For non-patients, self-reported Trait- and State-Anxiety, Mindfulness, Positive and Negative Affect and the General Health Questionnaire were completed. For patients, the Positive and Negative Syndrome Scale, Clinical Global Impression Severity Scale, Birchwood Insight Scale, Social Adjustment Scale, and Global Assessment of Functioning scale were completed. Test-retest reliability and responsiveness to intervention was assessed at 6 months. Whatever the sample, response frequencies showed normal distributions, and internal consistency was good (Cronbachs ). Scree plots of eigenvalues suggested a single factor in the samples. The one-dimensional solution yielded suboptimal fit indices. Construct validity was confirmed. Significant improvement in scores was observed before and after intervention. Test-retest variation was non-significant. Impairment of insight and cognition in the assessed patients implies that attention must be paid before applying WEMWBS to all patients. Nevertheless, WEMWBS proved valid and reliable in a further European population, suggesting transcultural validity for both monitoring and evaluation of interventions in healthy as well as chronic remitted schizophrenia populations.


Ollier M.,University Hospital Chu ntpied | Ollier M.,Center Jean Perrin | Chamoux A.,University Hospital Chu ntpied | Naughton G.,Australian Catholic University | And 5 more authors.
Chest | Year: 2014

Objective: Lung cancer is the most frequent malignant asbestos-related pathology and remains the most fatal cancer of industrialized countries. In heavy smokers, early detection of lung cancer with chest CT scan leads to a 20% mortality reduction. However, the use of CT scan screening for early detection of lung cancer in asbestos-exposed workers requires further investigation. This study aimed to determine whether CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer using a systematic review and meta-analysis. Methods: We reviewed all cohort studies involving chest CT scan screening in former asbestos-exposed workers. The search strategy used the following keywords: "asbestos," "lung cancer," "screening," and "occupation*" or "work." Databases were PubMed, Cochrane Library, Science Direct, and Embase. Results: Seven studies matched our inclusion criteria. Baseline screening detected 49 asymptomatic lung cancers among 5,074 asbestos-exposed workers. Of the 49 reported lung cancers, at least 18 were in the earliest stage(stage I), accessible to complete removal surgery. The prevalence of all lung cancers detected by CT scan screening in asbestos-exposed workers was 1.1%(95% CI, 0.6%-1.8%). Conclusions: CT scan screening in asbestos-exposed workers is effective in detecting asymptomatic lung cancer. Detection of lung cancer in asbestos-exposed workers using CT scanning is at least equal to the prevalence in heavy smokers(1%; 95% CI, 0.09%-1.1%) and also shared a similar proportion of stage I diagnoses. Screening asbestos-exposed workers could reduce mortality in proportions previously observed among heavy smokers and, thus, should not be neglected, particularly for individuals combining both exposures. © 2014 American College of Chest Physicians.


Lopez V.,University Hospital Chu ntpied | Chamoux A.,University Hospital Chu ntpied | Tempier M.,University Hospital Chu ntpied | Thiel H.,University Hospital Chu ntpied | And 6 more authors.
BMJ Open | Year: 2013

Objectives: To assess residual long-term microcirculation abnormalities by capillaroscopy, 15 years after retiring from occupational exposure to vinyl chloride monomer (VCM). Design: Cross-sectional study. Setting: Allier, one of the major areas of polyvinyl chloride production in France. Participants: We screened 761 (97% men) retired workers exposed to chemical toxics. Exposure to chemicals other than VCM excluded potential participants. Primary and secondary outcome measures: These participants underwent a medical examination including a capillaroscopy, symptoms of Raynaud and comorbidities, as well as a survey to determine exposure time, direct or indirect contact, type of occupation, smoking status and time after exposure. A double blind analysis of capillaroscopic images was carried out. A control group was matched in age, sex, type of occupation. Results: 179/761 retired workers were only exposed to VCM at their work, with 21 meeting the inclusion criteria and included. Exposure time was 29.8 ±1.9 years and time after exposure was 15.9±2.4 years. Retired workers previously exposed to VCM had significantly higher capillaroscopic modifications than the 35 controls: enlarged capillaries (19% vs 0%, p<0.001), dystrophy (28.6% vs 0%, p=0.0012) and augmented length (33% vs 0%, p<0.001). Time exposure was linked (p<0.001) with enlarged capillaries (R2=0.63), dystrophy (R2 =0.51) and capillary length (R2=0.36). They also had higher symptoms of Raynaud (19% vs 0%, p=0.007) without correlation with capillaroscopic modifications. Conclusions: Although VCM exposure was already known to affect microcirculation, our study demonstrates residual long-term abnormalities following an average of 15 years' retirement, with a time-related exposure response. Symptoms of Raynaud, although statistically associated with exposure, were not related to capillaroscopic modifications; its origin remains to be determined.


Chaplais E.,University Blaise Pascal | Chaplais E.,Australian Catholic University | Thivel D.,University Blaise Pascal | Greene D.,Australian Catholic University | And 7 more authors.
Journal of Bone and Mineral Metabolism | Year: 2015

The rising prevalence of overweight and obesity among pediatric populations has become a major global concern. The objective of this review is to demonstrate potential interactions between the products released by fat tissue and the hormonal production of bone tissue in obese children and adolescents. Advancing the understanding of the complex interactions between adipocyte and osteocyte activities may contribute to the mechanistic understanding of the body’s responses to weight loss during adolescence. This knowledge could also reveal any side effects encountered with these interventions. Currently, the concept of bone-adiposity crosstalk has not been fully elucidated, and the mechanisms remain controversial. Understanding the local interactions between the released products by fat tissue and hormones produced in bone tissue requires further investigations. © 2015, The Japanese Society for Bone and Mineral Research and Springer Japan.


PubMed | University Hospital, University Blaise Pascal, University Hospital Chu ntpied and Australian Catholic University
Type: Comparative Study | Journal: BMJ open | Year: 2014

Radiation delivered during CT is a major concern, especially for individuals undergoing repeated screening. We aimed to compare a new ultra-low-dose algorithm called Veo with the gold standard filtered back projection (FBP) for detecting pulmonary asbestos-related conditions.University Hospital CHU G. Montpied, Clermont-Ferrand, FranceAsbestos-exposed workers were recruited following referral to screening for asbestos-related conditions. Two acquisitions were performed on a 64-slice CT: the gold standard FBP followed by Veo reconstruction.Two radiologists independently assessed asbestos-related abnormalities, pulmonary nodules, radiation doses and image quality (noise).We included 27 asbestos-exposed workers (63.36.5years with 11.99.7years of asbestos exposure). We observed 297 pleural plaques in 20 participants (74%). All patients (100%) had pulmonary nodules, totalling 167 nodules. Detection rates did not differ for pleural plaques (Veo 87% vs FBP 97%, NS), pleural thickening (100% for both) and pulmonary nodules (80% for both). Interstitial abnormalities were depicted less frequently with Veo than FBP. False negative and false positive did not exceed 2.7%. Compared with FBP, Veo decreased the radiation dose up to 87% (Veo 0.230.07 vs FBP 1.830.88mSv, p<0.001). The objective image noise also decreased with Veo as much as 23% and signal-to-noise ratio increased up to 33%.A low-dose CT with Veo reconstruction substantially reduced radiation. Veo compared favourably with FBP in detecting pleural plaques, pleural thickening and pulmonary nodules. These results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions, especially regarding the low prevalence of interstitial abnormalities in this study.NCT01955018.


PubMed | Australian Catholic University, University Blaise Pascal and University Hospital Chu ntpied
Type: Journal Article | Journal: BMJ open | Year: 2016

A need exists for sustainable and clinically effective weight management interventions, suitable for preventing well-linked chronic disease such as diabetes and cardiovascular disease and some less investigated secondary conditions such as bone alteration. The ADIposity and BOne metabolism: effects of eXercise-induced weight loss in obese adolescents (ADIBOX) protocol was designed to provide a better understanding of the interaction between adipokines and bone hormones in adolescents with obesity and how a 10-month physical activity programme may affect these interactions.The ADIBOX protocol combines 2 studies. The first study involves a total of 68 adolescents aged 12-16years. This cross-sectional study will include both males and females (1:1 ratio), either living with obesity/overweight (n=34; body mass index (BMI) 97th centile and 85th centile) or normal weight (n=34; BMI<85th centile). The second study is a longitudinal study that will include 50 obese adolescent girls and track them over a period of 42weeks. Weight loss programme will consist of a combination of physical activity and a normocaloric diet. Bone and adiposity-related measurements will be performed every 14weeks. Both studies will assess participants anthropometric profile, nutrition and physical activity, body composition, bone densitometry and blood markers of bone, growth and adiposity.The ADIBOX protocol complies with the ethics guidelines for clinical research and has been approved by their respective ethics committee (Australian Catholic University Committee Ethic, Australia and Hospital Sud Est 1 committee, France). Findings from this protocol are expected to clarify the possible interactions between adiposity and bone in childhood obesity and will be disseminated at several research conferences and published articles in peer-reviewed journals.NCT02626273; Pre-results.

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