University Hospital of Amiens

University of Technology of Compiègne, France

University Hospital of Amiens

University of Technology of Compiègne, France
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Paccou J.,University Hospital of Amiens | Paccou J.,French Institute of Health and Medical Research | Fardellone P.,University Hospital of Amiens | Fardellone P.,French Institute of Health and Medical Research | And 2 more authors.
Current Opinion in Pulmonary Medicine | Year: 2013

PURPOSE OF REVIEW: This review highlights recently published data on the pathophysiology, guidelines and treatment of cystic fibrosis (CF)-related bone disease. RECENT FINDINGS: The exact role of the cystic fibrosis transmembrane conductance regulator (CFTR), specifically the ΔF508 allele, has been investigated in F508del-CFTR homozygous mice and the F508del-CFTR mutation may contribute to CF-related bone disease by slowing new bone formation. The European Cystic Fibrosis Society has issued guidelines for bone mineral density assessment, management of low-trauma fractures and bisphosphonate therapy. A systematic review based on meta-analyses reports that oral and intravenous bisphosphonates both improve bone mineral density in CF patients, but no data are available concerning the reduction of low-trauma fractures. SUMMARY: European Cystic Fibrosis Society guidelines may help physicians to improve the management of CF-related bone disease. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Godefroy O.,University Hospital of Amiens | Martinaud O.,University of Rouen | Verny M.,University Pierre and Marie Curie | Mosca C.,University Hospital of Grenoble | And 3 more authors.
Journal of Alzheimer's Disease | Year: 2014

Background: Dysexecutive disorders are common in early-stage Alzheimer's disease (AD) but have yet to be characterized in detail.Objective: The objectives of the present study based on validated diagnostic criteria were to determine the frequency and characterize the profile of behavioral and cognitive dysexecutive disorders in AD.Methods: 102 patients with AD (mild: n = 92; moderate: n = 10; mean MMSE score: 23.2) were examined with the GREFEX battery. Neuropsychological data were interpreted within a validated framework based on the performance levels of 780 control participants from the GREFEX study.Results: Dysexecutive syndrome was observed in 87.5% (95%CI: 79-96) of the AD patients (p = 0.0001). The dysexecutive disorder profile was characterized by prominent impairments of planning, inhibition flexibility and generation in the cognitive domain (p = 0.0001 as compared to controls for all) and global hypoactivity in the behavioral domain (p = 0.0001 as compared to controls).Conclusions: Dysexecutive syndrome is observed in over 80% of AD patients and has a distinct profile. Supplementary Material. © 2014 IOS Press and the authors. All rights reserved.


PubMed | Hunter Medical Research Institute, Sacred Heart University at Connecticut, Lille University Hospital Center, Royal College of Surgeons in Ireland and 23 more.
Type: | Journal: Alzheimer's & dementia (Amsterdam, Netherlands) | Year: 2017

The Stroke and Cognition consortium (STROKOG) aims to facilitate a better understanding of the determinants of vascular contributions to cognitive disorders and help improve the diagnosis and treatment of vascular cognitive disorders (VCD).Longitudinal studies with 75 participants who had suffered or were at risk of stroke or TIA and which evaluated cognitive function were invited to join STROKOG. The consortium will facilitate projects investigating rates and patterns of cognitive decline, risk factors for VCD, and biomarkers of vascular dementia.Currently, STROKOG includes 25 (21 published) studies, with 12,092 participants from five continents. The duration of follow-up ranges from 3months to 21years.Although data harmonization will be a key challenge, STROKOG is in a unique position to reuse and combine international cohort data and fully explore patient level characteristics and outcomes. STROKOG could potentially transform our understanding of VCD and have a worldwide impact on promoting better vascular cognitive outcomes.


Godefroy O.,University Hospital of Amiens | Azouvi P.,University Hospital of Garches | Robert P.,University Hospital of Nice | Roussel M.,University Hospital of Amiens | And 2 more authors.
Annals of Neurology | Year: 2010

Objective: Disorders of executive functions are among the most frequent cognitive deficits, but they remain poorly defined and are subject to heterogeneous assessment. To address this major issue, the Groupe de Réflexion sur l'Evaluation des Fonctions Exécutives (GREFEX) group has proposed criteria for behavioral and cognitive dysexecutive syndromes and has designed a battery including a specific heteroquestionnaire and 7 cognitive tests. We investigated the frequency of behavioral and cognitive dysexecutive disorders in patients suffering from various diseases and the association of these disorders with loss of autonomy. Methods A total of 461 patients aged between 16 and 90 years with severe traumatic brain injury, stroke, mild cognitive impairment, Alzheimer disease, multiple sclerosis, and Parkinson disease were recruited into this prospective cohort study by 21 centers between September 2003 and June 2006. Behavioral and cognitive dysexecutive disorders were examined using the GREFEX battery. Results A dysexecutive syndrome was observed in 60% of patients, concerning both behavioral and cognitive domains in 26% and dissociated in 34%. All behavioral and cognitive dysexecutive disorders discriminated (p = 0.001, all) patients from controls. The pattern of cognitive syndrome differed (p = 0.0001) according to the disease. Finally, behavioral (odds ratio [OR], 4.6; 95% confidence interval [CI], 2. 3-9.1; p = 0.0001) and cognitive (OR, 3.36; 95% CI, 1.7-6.6; p = 0.001) dysexecutive syndromes and Mini Mental State Examination score (OR, 0.79; 95% CI, 0.68-0.91; p = 0.002) were independent predictors of loss of autonomy. Interpretation This study provided criteria of dysexecutive syndrome and showed that both behavioral and cognitive syndromes contribute to loss of autonomy. Profiles vary across patients and diseases, and therefore systematic assessment of behavioral and cognitive disorders in reference to diagnostic criteria is needed. Copyright © 2010 American Neurological Association.


Godefroy O.,University Hospital of Amiens | Fickl A.,Soissons Hospital | Roussel M.,University Hospital of Amiens | Auribault C.,Soissons Hospital | And 4 more authors.
Stroke | Year: 2011

Background And Purpose- A screening test is required to improve the diagnosis of poststroke cognitive impairment. The Montreal Cognitive Assessment (MoCA), a newly designed screening test, has been found to be more sensitive than Mini-Mental State Examination (MMSE), but its clinical value has not been established by means of a comprehensive neuropsychological battery. This study was designed to assess the value of MoCA and MMSE to detect poststroke cognitive impairment determined by a neuropsychological battery. Methods- Both screening tests and a neuropsychological battery were administered during the acute phase in 95 patients referred for recent infarct or hemorrhage. Raw MMSE and MoCA scores were used with published cutoffs and new cutoff scores for MMSE and MoCA were also computed after adjustment for age and education. Results- Using raw scores, MoCA was more frequently impaired (P=0.0001) than MMSE. MoCA showed good sensitivity (sensitivity, 0.94) but moderate specificity (specificity, 0.42; positive predictive value, 0.77; negative predictive value, 0.76), whereas an inverse profile was observed for MMSE (sensitivity, 0.66; specificity, 0.97; positive predictive value, 0.98; negative predictive value, 0.58). Adjusted scores with new cutoffs (MMSEadj ≤24, MoCAadj ≤20) provided good sensitivity and very good specificity for both tests (MMSEadj: sensitivity, 0.7, specificity, 0.97, positive predictive value, 0.98, negative predictive value, 0.61; MoCAadj: sensitivity, 0.67, specificity, 0.9, positive predictive value, 0.93, negative predictive value, 0.57). On receiver operating characteristic curve analysis, areas under the curve of all scores were >0.88. Conclusions- The previously reported high sensitivity of MoCA is associated with low specificity. Both screening tests are moderately sensitive to acute poststroke cognitive impairment. This study provides indications for the diagnosis of poststroke cognitive impairment. © 2011 American Heart Association, Inc.


Roussel M.,University Hospital of Amiens | Dujardin K.,University Hospital of Lille | Henon H.,University Hospital of Lille | Godefroy O.,University Hospital of Amiens
Brain | Year: 2012

Although frontal dysexecutive disorders are frequently considered to be due to working memory deficit, this has not been systematically examined and very little evidence is available for impairment of working memory in frontal damage. The objective of this study was to examine the components of working memory, their anatomy and the relations with executive functions in patients with stroke involving the frontal or posterior cortex. The study population consisted of 29 patients (frontal: n = 17; posterior: n = 12) and 29 matched controls. Phonological loop (letter and word spans, phonological store; rehearsal process), visuospatial sketchpad (visuospatial span) and the central executive (working memory span, dual task and updating process) were examined. The group comparison analysis showed impairment in the frontal group of: (i) verbal spans (P < 0.03); (ii) with a deficit of the rehearsal process (P = 0.006); (iii) visuospatial span (P = 0.04); (iv) working memory span (P = 0.001) that disappeared after controlling for verbal span and (v) running memory (P = 0.05) unrelated to updating conditions. The clinical anatomical correlation study showed that impairment of the central executive depended on frontal and posterior lesion. Cognitive dysexecutive disorders were observed in 11/20 patients with central executive deficit and an inverse dissociation was observed in two patients. Receiver operating characteristic curve analysis indicated that cognitive dysexecutive disorders had the highest ability to discriminate frontal lesions (area under curve = 0.844, 95% confidence interval: 0.74-0.95; P = 0.0001; central executive impairment: area under curve = 0.732, 95% confidence interval: 0.57-0.82; P = 0.006). This study reveals that frontal lesions induce mild impairment of short-term memory associated with a deficit of the rehearsal process supporting the role of the frontal lobe in this process; the central executive depends on lesions in the frontal lobe and posterior regions accounting for its low frequency and the negative results of group studies. Finally, the frontal dysexecutive syndrome cannot be attributed to central executive impairment, although it may contribute to some dysexecutive disorders. © The Author (2012). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved.


Martin B.A.,Ecole Polytechnique Federale de Lausanne | Reymond P.,Ecole Polytechnique Federale de Lausanne | Novy J.,University of Lausanne | Baledent O.,University Hospital of Amiens | Stergiopulos N.,Ecole Polytechnique Federale de Lausanne
American Journal of Physiology - Heart and Circulatory Physiology | Year: 2012

Coupling of the cardiovascular and cerebrospinal fluid (CSF) system is considered to be important to understand the pathophysiology of cerebrovascular and craniospinal disease and intrathecal drug delivery. A coupled cardiovascular and CSF system model was designed to examine the relation of spinal cord (SC) blood flow (SCBF) and CSF pulsations along the spinal subarachnoid space (SSS). A onedimensional (1-D) cardiovascular tree model was constructed including a simplified SC arterial network. Connection between the cardiovascular and CSF system was accomplished by a transfer function based on in vivo measurements of CSF and cerebral blood flow. A 1-D tube model of the SSS was constructed based on in vivo measurements in the literature. Pressure and flow throughout the cardiovascular and CSF system were determined for different values of craniospinal compliance. SCBF results indicated that the cervical, thoracic, and lumbar SC each had a signature waveform shape. The cerebral blood flow to CSF transfer function reproduced an in vivolike CSF flow waveform. The 1-D tube model of the SSS resulted in a distribution of CSF pressure and flow and a wave speed that were similar to those in vivo. The SCBF to CSF pulse delay was found to vary a great degree along the spine depending on craniospinal compliance and vascular anatomy. The properties and anatomy of the SC arterial network and SSS were found to have an important impact on pressure and flow and perivascular fluid movement to the SC. Overall, the coupled model provides predictions about the flow and pressure environment in the SC and SSS. More detailed measurements are needed to fully validate the model. © 2012 the American Physiological Society.


PubMed | Lille 2 University of Health and Law and University Hospital of Amiens
Type: | Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery | Year: 2017

Objective To analyze the survival rate of a nonselected pyriform sinus cancer population. Study Design Case series with chart review. Setting University hospital. Subjects and Methods A total of 122 patients were included in this study covering the 2002-2008 period. All patients had squamous cell carcinoma originating from the pyriform sinus. Survival and prognostic factors were analyzed. Results The 3- and 5-year overall survival rates were 39.7% and 2.4%, respectively. The 3- and 5-year survival rates without recurrence were 34% and 27%, respectively. The median survival rates by UICC stage were as follows: stage 1 and 2 patients, 60 months; stage 3, 40 months; stage 4, 19 months. Stage 4 patients had a lower median survival rate than other stages ( P = .039). The 5-year survival rate was 46% for patients having T3-T4 operable cancers treated by surgery vs 45% for patients treated by laryngeal conservation protocol (not significant). The 5-year survival rate for patients having nonoperable T4 cancers was 17.2%. The 3- and 5-year overall survival rates of N0 patients was significantly higher than N1 patients ( P = .042). N2 and N3 patients had 100% 5-year mortality. Conclusion This study showed that overall survival and therapeutic management depend on the initial stage of pyriform sinus cancer, notably on the N status. In particular, nonoperable T4 pyriform sinus cancer and N2 and N3 patients had a very poor prognosis. A laryngeal conservation protocol seemed as effective as surgical management in terms of survival.


Page C.,University Hospital of Amiens | Duverlie G.,University of Picardie Jules Verne | Sevestre H.,University Hospital of Amiens | Desailloud R.,University Hospital of Amiens
Journal of Medical Virology | Year: 2015

Erythrovirus B19 (EVB19) has been incriminated, over recent years, in the onset and/or pathogenesis of many diseases, especially autoimmune thyroid diseases. This review of the literature (published over the last 40 years using Pubmed and Science Direct search engines) was designed to define the role of EVB19, particularly in autoimmune thyroid diseases.Two cases of subacute thyroiditis, one case of Graves' disease (associated with type 1 diabetes and rheumatoid arthritis), and one case of Hashimoto's thyroiditis following acute EVB19 infection were reported. A retrospective case-control study in a pediatric population demonstrated the role of EVB19 in Hashimoto's thyroiditis. Four retrospective studies of pathology slides (including PCR, immunohistochemistry or in situ hybridization) and a prospective case-control study on pathology slides demonstrated the presence of EVB19 in thyroid tissue of patients with benign multinodular goiter, Graves' disease, autoimmune thyroiditis (including Hashimoto's thyroiditis), and thyroid cancer. EVB19 can be demonstrated in the thyroid gland in a wide range of diseases. Although acute EVB19 infection could theoretically trigger autoimmune thyroid disease, there is currently no evidence that EVB19 plays a specific role in the pathophysiology of autoimmune thyroid diseases. © 2014 Wiley Periodicals, Inc.


Paccou J.,University Hospital of Amiens | Paccou J.,French Institute of Health and Medical Research | Brazier M.,French Institute of Health and Medical Research | Mentaverri R.,French Institute of Health and Medical Research | And 5 more authors.
Atherosclerosis | Year: 2012

Individuals with rheumatoid arthritis (RA) are at increased risk for morbidity and mortality from cardiovascular disease. Excess cardiovascular mortality in RA patients cannot be fully explained by conventional cardiovascular risk factors. The purpose of this review is to discuss recent progress concerning the prevalence and pathophysiological aspects of vascular calcification in RA. RA patients have early-onset diffuse calcification involving multiple vascular beds compared to age and sex-matched controls. Pathogenesis of vascular calcification in RA patients is not fully understood, but specific mediators such as proinflammatory cytokines and not global inflammation could be involved. The possible link between osteoporosis and vascular calcification in RA will not be discussed. Finally, potential targets to reduce vascular calcification in RA will be discussed. © 2012 Elsevier Ireland Ltd.

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