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Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children:results from the French pediatric national registry

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World Journal of Pediatrics 2024年第6期20卷 611-620页

作者： Marguerite Lockhart-Bouron Noemie Vanel Michael Levy Anais R.Briant Etienne Javouhey Sophie Breinig Julia Dina Marion Caseris Francois Angoulvant Stephane Leteurtre Morgan Recher David W.Brossier Univ.Lille CHU LilleULR 2694-METRICS:Evaluation Des Technologies de Sante Et Des Pratiques Medicales59000LilleFrance Pediatric Intensive Care Unit CHU de MarseilleMarseilleFrance Pediatric Intensive Care Unit CHU Robert-DebreAssistance Publique Hopitaux de ParisParisFrance UniversitéParis-Cite ParisFrance Biostatistics and Clinical Research Unit CHU de Caen Normandie14000CaenFrance Pediatric Intensive Care Hospices Civils de LyonLyonFrance Neonatal andPediatric IntensiveCare Unit Children's HospitalToulouseFrance Virology department INSERM U1311 DynamicureUniv CAEN NormandieCHU de Caen14000 CaenFrance Medical School Universite Caen Normandie14000 CaenFrance department of Pediatrics CHU Robert-DebréAssistance Publique Hopitaux de ParisParisFrance department Women-Mother-Child Service of PediatricsLausanne University Hospital(CHUV)LausanneSwitzerland Pediatric Intensive Care Unit Réanimation Et Soins Intensifs PéediatriquesCHU de CAENAvenue de La Cote de Nacre14000 CaenFrance chu Sainte Justine Research Center MontréalCanada

Background Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is responsible for an important mortality rate *** aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit(PICU).Secondary objectives were to identify risk factors for *** This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions(PCRs)[acute corona virus disease 2019(COVID-19)or incidental SARS-CoV-2 infection]and/or pediatric inflammatory multisystem syndrome(PIMS)recorded in the French PICU registry(PICURe)between September 1,2021,and August 31,*** patients were classified and compared according to their living status at the end of their PICU *** patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive *** imputability of SARS-CoV-2 as the cause of death was classified into four categories:certain,very probable,possible,or unlikely,and was defined by any of the first three *** There were 948 patients included of which 43 died(4.5%).From this,26 deaths(67%)could be attributed to SARS-CoV-2 infection,with an overall mortality rate of 2.8%.The imputability of death to SARS-CoV-2 was considered certain in only one case(O.1%).deceased patients suffered more often from comorbidities,especially heart disease,neurological disorders,hematological disease,cancer,and *** of the deceased patients were admitted for pediatric inflam-matory multisystem syndrome(PIMS).Mortality risk factors were male gender,cardiac comorbidities,cancer,and acute respiratorydistress *** SARS-CoV-2 mortality in the French pediatric population was *** though the imputability of SARS-Cov-2 on mortality was considered in almost two-thirds of cases,this imputability was considered certain in only one case.

关键词： death Pediatric intensive care unit SARS-CoV-2

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Role of endoscopic ultrasound in the molecular diagnosis of pancreatic cancer

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World Journal of Gastroenterology 2014年第31期20卷 10758-10768页

作者： Barbara Bournet Marion Gayral Jérme Torrisani Janick Selves Pierre Cordelier Louis Buscail department of Gastroenterology CHU Toulouse Rangueil University of Toulouse INSERM UMR 1037 CHU Toulouse Rangueil University of Toulouse department of Pathology CHU Toulouse Purpan University of Toulouse

Pancreatic ductal adenocarcinoma remains one of the most deadly types of tumor. Endoscopic ultrasoundguided fine-needle aspiration(EUS-FNA) is a safe, cost-effective, and accurate technique for evaluating and staging pancreatic tumors. However, EUS-FNA may be inconclusive or doubtful in up to 20% of cases. This review underlines the clinical interest of the molecular analysis of samples obtained by EUS-FNA in assessing diagnosis or prognosis of pancreatic cancer, especially in locally advanced tumors. On EUS-FNA materials DNA, mRNA and miRNA can be extracted, amplified, quantified and subjected to methylation assay. Kras mutation assay, improves diagnosis of pancreatic cancer. When facing to clinical and radiological presentations of pseudo-tumorous chronic pancreatitis, wildtype Kras is evocative of benignity. Conversely, in front of a pancreatic mass suspected of malignancy, a mutated Kras is highly evocative of pancreatic adenocarci-noma. This strategy can reduce false-negative diagnoses, avoids the delay of making decisions and reduces loss of surgical resectability. Similar approaches are conducted using analysis of miRNA expression as well as Mucin or markers of invasion(S100P, S100A6, PLAT or PLAU). Beyond the diagnosis approach, the prediction of response to treatment can be also investigated form biomarkers expression within EUS-FNA materials.

关键词： Pancreatic ductal adenocarcinoma Endoscopic ultrasound-guided fine-needle aspiration Solid pancreatic mass KRAS-mutation assay qPCR analysis Micro-RNA Chronic pancreatitis

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High tacrolimus intra-patient variability is associated with graft rejection,and de novo donor-specific antibodies occurrence after liver transplantation

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World Journal of Gastroenterology 2018年第16期24卷 1795-1802页

作者： Arnaud del Bello Nicolas Congy-Jolivet Marie Danjoux Fabrice Muscari Laurence Lavayssière Laure Esposito Anne-Laure Hebral Julie Bellière Nassim Kamar department of Nephrology and Organ Transplantation CHU RangueilToulouse 31000France Université Paul Sabatier Toulouse 31000France Molecular Immunogenetics Laboratory Facultéde Médecine PurpanIFR150(INSERM)Montréal H3G 1Y6France department of Immunology CHU de ToulouseHopital de RangueilCHU de ToulouseToulouse 31000France department of Pathology Institut Universitaire du CancerCHU Toulouse 31000France department of Surgery and Liver Transplantation Toulouse 31000France INSERM IFR-BMTCHU PurpanToulouse 31000France

AIM To investigate the role of tacrolimus intra-patient variability(IPV) in adult liver-transplant *** We retrospectively assessed tacrolimus variability in a cohort of liver-transplant recipients and analyzed its effect on the occurrence of graft rejection and de novo donor-specific antibodies(dn DSAs), as well as graft survival during the first 2 years posttransplantation. Between 02/08 and 06/2015, 116 patients that received tacrolimus plus mycophenolate mofetil(with or without steroids) were included. RESULTS Twenty-two patients(18.5%) experienced at least one acute-rejection episode(BPAR). Predictive factors for a BPAR were a tacrolimus IPV of > 35% [OR = 3.07 95%CI(1.14-8.24), P = 0.03] or > 40% [OR = 4.16(1.38-12.50), P = 0.01), and a tacrolimus trough level of developed at least one dn DSA during the follow-up. Tacrolimus IPV [coded as a continuous variable: OR = 1.1, 95%CI(1.0-1.12), P = 0.006] of > 35% [OR = 4.83, 95%CI(1.39-16.72), P = 0.01] and > 40% [OR = 9.73, 95%CI(2.65-35.76), P = 0.001] were identified as predictors to detect dn DSAs. IPV did not impact on patient-or graft-survival rates during the follow-up. CONCLUSION Tacrolimus-IPV could be a useful tool to identify patients with a greater risk of graft rejection and of developing a de novo DSA after liver

关键词： Variability Liver transplantation Donorspecific antibodies Immunosuppression

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S1P: the elixir of life for naive T cells

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Cellular & Molecular Immunology 2018年第7期15卷 657-659页

作者： Michaël Pérès Anne Montfort Nathalie Andrieu-Abadie Céline Colacios Bruno Ségui INSERM UMR1037 Centre de Recherches en Cancérologie de ToulouseToulouse 31037France Facultéde pharmacie UniversitéToulouse III Paul-SabatierToulouse 31062France Laboratoire d’hématologie CHU de ToulouseToulouse 31059France Equipe Labellisée Ligue Contre Le Cancer Toulouse 31037France Correspondence:Professor B SéguiPhDINSERMUMR1037 CRCTCentre de Recherches en Cancérologie de Toulouse2 avenue Hubert CurienToulouse 31037France

During their life,T cells are constantly circulating throughout the ***-1-phosphate(S1P),a sphingolipid metabolite,triggers T cell egress from the thymus and secondary lymphoid organs(SLO)into the lymph and the *** phenomenon is dependent on the S1P gradient between lymphoid organs(including thymus and SLO)and the lymphatic and blood vessels,which exhibit low,intermediate and high S1P levels,respectively.T cells follow the S1P gradient via the engagement of the G-protein-coupled receptor S1P receptor 1(S1P1)expressed on T cells.1 S1P production is regulated by various sphingolipid-metabolizing *** sphingosine kinases 1 and 2(SKs),encoded by Sphk1 and Sphk2,phosphorylate the sphingosine(Sph)into ***,S1P can be dephosphorylated to Sph by S1P phosphatases 1 and 2,encoded by Sgpp1 and ***,S1P can be irreversibly degraded by the S1P Lyase(SPL),encoded by Sgpl1,into phosphoethanolamine and hexadecenal.

关键词： organs al. lymphoid

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Early plasmapheresis and rituximab for acute humoral rejection after ABO-compatible liver transplantation

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World Journal of Gastroenterology 2009年第27期15卷 3426-3430页

作者： Nassim Kamar Laurence Lavayssière Fabrice Muscari Janick Selves Céline Guilbeau-Frugier Isabelle Cardeau Laure Esposito Olivier Cointault Marie Béatrice Nogier Jean Marie Peron Philippe Otal Marylise Fort Lionel Rostaing department of Nephrology Dialysis and Multi-Organ Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U858 IFR 31 CHU Rangueil TSA 50032 31059 Toulouse Cédex 9 France department of Liver Transplantation CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France department of Histopathology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France department of Histopathology CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France department of Radiology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France department of Immunology CHU RangueilTSA 50032 31059 Toulouse Cédex 9 France INSERM U563 IFR 30 CHU PurpanTSA 50032 31059 Toulouse Cédex 9 France

Acute humoral rejection （AHR） is uncommon after ABO- compatible liver transplantation. Herein, we report two cases of AHR treated with plasmapheresis and rituximab in two ABO-compatible liver-transplant patients with preformed anti-human leukocyte antigen donor-specific antibodies. Patient 1 experienced a biopsy-proven AHR at day 10 post-transplant. She was treated by steroid pulses, and OKT3. Because of persisting signs of biopsy-proven AHR at day 26, she was treated by plasmapheresis and rituximab. Uver enzyme levels did not improve, and she died on day 41. Patient 2 experienced a biopsy-proven AHR on day 10 post-transplant. She was treated by steroid pulses, plasmapheresis, and rituximab. Liver enzymes returned to within normal range 18 d after diagnosis. Uver biopsies, at 3 and 9 mo post-transplant, showed complete resolution of AHR. We conclude that plasmapheresis should be started as soon as AHR is diagnosed, and be associated with a B-cell depleting agent. Rituximab may be considered as a first-line therapy.

关键词： Acute humoral rejection Liver transplantation Donor-specific antibodies Rituximab Plasmapheresis

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Characterising acute ischaemic stroke thrombi:insights from histology,imaging and emerging impedance-based technologies

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Stroke & Vascular Neurology 2022年第4期7卷 353-363页

作者： Smita Patil Jean Darcourt Pierluca Messina Franz Bozsak Christophe Cognard Karen Doyle CÚRAM SFI Research Centre for Medical DevicesNational University of Ireland GalwayGalwayIreland Neuroradiology CHU de ToulouseToulouseFrance Sensome MassyFrance Physiology National University of Ireland GalwayGalwayIreland

Treatment of acute ischaemic stroke(AIS)focuses on rapid recanalisation of the occluded *** recent years,advent of mechanical thrombectomy devices and new procedures have accelerated the analysis of thrombi retrieved during the endovascular thrombectomy *** ongoing developments and progress in AIS imaging techniques,it is not yet possible to conclude definitively regarding thrombus characteristics that could advise on the probable efficacy of thrombolysis or thrombectomy in advance of *** devices with dignostic capabilities or new clinical imaging approaches are needed for better treatment of AIS *** this review,what is known about the composition of the thrombi that cause strokes and the evidence that thrombus composition has an impact on success of acute stroke treatment has been *** review also discusses the evidence that AIS thrombus composition varies with aetiology,questioning if suspected aetiology could be a useful indicator to stroke physicians to help decide the best acute course of ***,this review discusses the evidence that current widely used radiological imaging tools can predict thrombus *** use of new emerging technologies based on bioimpedance,as imaging modalities for diagnosing AIS and new medical device tools for detecting thrombus composition in situ has been *** bioimpedance would be beneficial for gaining new insights into in situ thrombus composition that could guide choice of optimum treatment approach is also reviewed.

关键词： throm acute impedance

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Identification of biomarkers of human pancreatic adenocarcinomas by expression profiling and validation with gene expression analysis in endoscopic ultrasound-guided fine needle aspiration samples

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World Journal of Gastroenterology 2006年第21期12卷 3344-3351页

作者： Henrik Laurell Michèle Bouisson Philippe Berthelémy Philippe Rochaix Sébastien Déjean Philippe Besse Christiana Susini Lucien Pradayrol Nicole Vaysse Louis Buscail INSERM U531 IFR31 Institut Louis BugnardBP 8422531432 Toulouse Cedex 4France Service de Gastroentérologie Centre Hospitaller de Pau PauFrance Laboratoire d'Anatomo-Pathologie Institut Claudius Regaud ToulouseFrance Laboratoire de Statistique et Probabilités Université Paul Sabatier ToulouseFrance INSERM U531 IFR31 Institut Louis BugnardBP 8422531432 Toulouse Cedex 4France Service de Gastroenterologie et de la NutritionCHU RangueilToulouseFrance

AIM： To compare gene expression profiles of pancreatic adenocarcinoma tissue specimens, human pancreatic and colon adenocarcinoma and leukemia cell lines and normal pancreas samples in order to distinguish differentially expressed genes and to validate the differential expression of a subset of genes by quantitative real-time RT-PCR （RT-QPCR） in endoscopic ultrasound-guided fine needle aspiration （EUS-guided FNA） ***： Commercially dedicated cancer cDNA macroarrays （Atlas Human Cancer 1.2） containing 1176 genes were used. Different statistical approaches （hierarchical clustering, principal component analysis （PCA） and SAM） were used to analyze the expression data. RT-QPCR and immunohistochemical studies were used for validation of ***： RT-QPCR validated the increased expression of LCN2 （lipocalin 2） and for the first time PLAT （tissue-type plasminogen activator or tPA） in malignant pancreas as compared with normal pancreas. Immunohistochemical analysis confirmed the increased expression of LCN2 protein localized in epithelial cells of ducts invaded by carcinoma. The analysis of PLAT and LCN2 transcripts in 12 samples obtained through EUS-guided FNA from patients with pancreatic adenocarcinoma showed significantly increased expression levels in comparison with those found in normal tissues, indicating that a sufficient amount of high quality RNA can be obtained with this ***： Expression profiling is a useful method to identify biomarkers and potential target genes. Molecular analysis of EUS-guided FNA samples in pancreatic cancer appears as a valuable strategy for the diagnosis of pancreatic adenocarcinomas.

关键词： Pancreas Colon Adenocarcinoma Gene expression profiling Endoscopic ultrasonography Ultrasound Fine needle aspiration

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Investigation of the efficiency of intrastromal ring segments with cross-linking using different sequence and timing for keratoconus

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International Journal of Ophthalmology(English edition) 2015年第4期8卷 703-708页

作者： Xuan-Li Liu Ping-Hua Li Pierre Fournie Francois Malecaze department of Ophthalmology of Chongqing Medical University department of Ophtalmology CHU of ToulouseHopital Purpan

· AIM: To evaluate and compare the efficacy and stability of intrastromal corneal ring segment(ICRs)implantation with cross-linking(CXL) using different sequence and timing.· METHODS: In this single retrospective study, 86 keratoconic eyes subjected the ICRs implantation. We analyzed only 41 eyes that had complete *** were divided into three groups: ICRs implantation was applied only(group normal), ICRs first followed by CXL immediately(group CXL-S), CXL first followed by ICRs long after(group CXL-B). The visual acuity,refractive results, keratometry were compared preoperatively and 1y postoperatively. Their differences among the three groups were also analyzed.·RESULTS: Group normal comprised 25 eyes, group CXL-S 8 eyes, and group CXL-B 8 eyes. There were improvements in the mean uncorrected distance visual acuity(UDVA) and the mean corrected distance visual acuity(CDVA) compared preoperatively and 1y postoperatively [UDVA: 0.31(P =0.030) logarithmic minimum angle of resolution(log MAR) group normal, 0.4(P =0.020) group CXL-S, 0.45(P =0.001) group CXL-B;CDVA : 0. 21 log MAR( P = 0. 013) group normal, 0. 30(P =0.036) group CXL-S; 0.26(P =0.000) group CXL-B].The refractive and topographic outcomes also showed improvements. In terms of comparisons among the three groups, all the P values were above 0.05, showing no significant difference. But only group CXL-B had improvement in UDVA and CDVA for all the patients.·CONCLUSION: With safety and good visual outcomes,ICRs implantation is a viable alternative for *** significant difference was found among these three groups.

关键词： keratoconus intrastromal corneal ring segment cross-linking

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Suicidal Ideation and Attempts during Middle Childhood: Associations with Subjective Quality of Life and depression

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Open Journal of Medical Psychology 2013年第3期2卷 93-100页

作者： Sylvie Bourdet-Loubère Jean-Philippe Raynaud chu de toulouse Toulouse France Laboratoire LCPI Université Toulouse II Toulouse France

Background: Confronted to the increasing suicide rate in children, clinicians have to better understand and predict suicide-related behaviours (SRBs) in children with and without depressive symptoms. Aims: To investigate associations among suicidal tendencies (thoughts and/or attempts), depression and children’s perceptions of subjective quality of life. Methods: This was a cross-sectional study of 157 children of 6 - 13-year-old. Results: Children who attempted or thought of suicide reported goodless subjective quality of life than nonsuicidal children did, and children who thought of or attempted suicide reported higher levels of depressive symptoms than nonsuicidal children. Limitations: A more rigorous approach to investigating suicidal ideation and depressive symptomatology as a diagnostic interview based on the DSM-IV-TR will be valuable to future progress in understanding children’s suicidality. Conclusions: Results may reflect the confirmation of depressive symptoms as risk factors for suicidality and underline the high importance of social and emotional life context among suicidal children. For this reason, more effective recognition and comprehension of the underlying affective and social conditions of children with suicidality have special importance to prevent future suicidal behaviour during adolescence.

关键词： Suicide Ideation Suicide Attempt Subjective Quality of Life depression Children

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脊柱关节炎病人与腰痛病人腰椎MRI上炎性后弓异常的发病率比较

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国际医学放射学杂志 2020年第1期 121-122页

作者： H.Braun C.Geniez Y.degboe A.Constantin A.Cantagrel D.Nigon 王雪杰 Centre de rhumatologie CHU de Toulouse Université Paul Sabatier Toulouse Ⅲ

目的旨在比较中轴型脊柱关节炎(axSpA)和腰背痛(LBP)病人在腰椎MRI上炎性后弓异常的发生率。方法选择符合2009年国际脊柱关节炎协会(ASAS)标准的axSpA

关键词：关节炎 MRI 发病率

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