Nicoleta Reinald

Université Paris-Est Créteil Val de Marne - Université Paris 12, Créteil, Île-de-France, France

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Publications (7)33.22 Total impact

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    ABSTRACT: We aim to assess the prevalence and associated factors of clinical depression in older patients with cancer. We studied a prospective cohort of cancer patients aged ≥70 years and referred to geriatric oncology clinics between 2007 and 2012. A multidimensional geriatric assessment was performed before choosing the cancer-treatment strategy. Clinical depression was diagnosed by senior geriatricians by a semi-structured interview. It encompassed criteria of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) and of the International Classification of Diseases (10th edition). Multivariate logistic regression was performed. Of 1121 consecutive patients, 1092 had available data (mean age, 80.4 years; women, 48.8%; metastases, 51.3%; cancer location: colorectal 21.1%, breast 16.8%, kidney, bladder or urinary tract 14.0%, and prostate 11.4%). The overall prevalence of clinical depression was 28.4% (95% confidence interval, 25.7-31.2). Factors independently associated with clinical depression by multivariate analysis adjusting for all following factors plus gender, and metastasis were impaired mobility (adjusted odds ratio [aOR], 2.35; 1.59-3.46), impaired functional status defined as Eastern Cooperative Oncology Group Performance Status ≥ 2 (aOR, 2.39; 1.66-3.43) or as activities of daily living < 6 (aOR, 2.43; 1.73-3.41), inpatient status (aOR, 1.68; 1.20-2.37), inadequate social support (aOR, 1.66; 1.16-2.37), cognitive impairment (aOR, 1.76; 1.24-2.49), polypharmacy defined as five or more non-antidepressant drugs (aOR, 1.65; 1.14-2.38), multimorbidity (aORadditional CIRS-G point , 1.08; 1.04-1.12), and cancer-related pain (aOR, 1.76; 1.26-2.46). In older patients with as-yet untreated cancer at various sites and stages, clinical depression was highly prevalent. Clinical depression was independently associated with several geriatric assessment findings (impaired mobility and function, inadequate social support, cognitive impairment, polypharmacy, and multimorbidity) independently from gender, tumor site, and metastatic status. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    Psycho-Oncology 06/2015; DOI:10.1002/pon.3886 · 2.44 Impact Factor
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    ABSTRACT: To identify Comprehensive Geriatric Assessment (CGA) components independently associated with changes in planned cancer treatment. We prospectively included 375 consecutive elderly patients with cancer (ELCAPA01 study) assessed by geriatricians using the CGA. Multivariate analysis was used to identify factors associated with changes in the cancer treatment (intensification, decrease, or delayed > 2 weeks). Change was defined as a difference between the initial treatment proposal and the final treatment selected in a multidisciplinary meeting. Mean age was 79.6 years (standard deviation [SD], 5.6 years), and 197 (52.5%) were women. The most common tumor location was the digestive system (58.7%). The mean number of comorbidities was 4.2 (SD, 2.7) per patient, and the mean Cumulative Illness Rating Scale for Geriatrics score was 11.8 (SD, 5.3). After the CGA, the initial cancer treatment plan was modified for 78 (20.8%) of 375 patients (95% CI, 16.8 to 25.3), usually to decrease treatment intensity (63 [80.8%] of 78 patients). By univariate analysis, cancer treatment changes were associated with Eastern Cooperative Oncology Group performance status ≥ 2 (73.3% in the group with changes v 41.1% in the in the group without changes; P < .001), dependency for one or more activities of daily living (ADL; 59.0% v 24.2%; P < .001), malnutrition (81.8% v 51.2%; P < .001), cognitive impairment (38.5% v 24.9%; P = .023), depression (52.6% v 21.7%; P < .001), and greater number of comorbidities (mean, 4.8 [SD, 2.9] v 4.0 [SD, 2.6]; P = .02). By multivariate analysis, factors independently associated with cancer treatment changes were a lower ADL score (odds ratio [OR], 1.25 per 0.5-point decrease; CI, 1.04 to 1.49; P = .016) and malnutrition (OR, 2.99; CI, 1.36 to 6.58; P = .007). Functional status assessed by the ADL score and malnutrition were independently associated with changes in cancer treatment.
    Journal of Clinical Oncology 06/2011; 29(27):3636-42. DOI:10.1200/JCO.2010.31.0664 · 18.43 Impact Factor
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    ABSTRACT: To develop a reproducible and accessible model of elastase-induced fusiform aneurysm in carotid rabbit arteries. Elastase, at a concentration of 1-30 U, was incubated into the lumen of carotid rabbit arteries. Four weeks later, angiography, histomorphometry, immunohistochemistry and zymography were performed. The optimal concentration of elastase in this model was 3 U according to the balance between mortality and thrombosis rates. Indeed, at 3 U, external carotid diameter increased from 1.9 +/- 0.1 to 3.1 +/- 0.4 mm (p < 0.0001) associated with degradation of elastic fibers, matrix metalloproteinase-9 secretion, apoptosis and macrophage infiltration. Our study underlines that abdominal aortic aneurysm can be reliably duplicated in an elastase-induced aneurysm in carotid artery, a much more accessible vessel.
    Journal of Vascular Research 09/2009; 47(1):61-8. DOI:10.1159/000232575 · 2.90 Impact Factor
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    Archives of Cardiovascular Diseases 03/2009; 102. DOI:10.1016/S1875-2136(09)72441-6 · 1.84 Impact Factor
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    ABSTRACT: Embryo-like gingival healing properties are attributed to the gingival fibroblast (GF) and could be used as a model for other types of healing dysfunctions. Abdominal aortic aneurysm (AAA) formation is associated with elastin degradation and increase in matrix metalloproteinase (MMP)-9 activity. We aimed to validate the concept of using GF healing properties in arteries. We evaluated MMP-9 and its tissue inhibitor (TIMP-1) in rabbit aortic rings cultured in collagen gels with or without GFs and observed throughout 21 days. We also performed cocultures of human smooth muscle cells (hSMCs) with either gingival, dermal, or adventitial fibroblasts, and alone (control). In control arteries, elastic fibers became spontaneously sparse. In presence of GFs, elastic fibers were preserved. There was a dramatically reduced protein level of MMP-9 in coculture of aorta and GFs, in contrast with control aorta. MMP-9 expression was unaffected by GFs. MMP-9 inhibition was related to increased TIMP-1 secretion, TIMP-1 forming a complex with MMP-9. Cell cocultures of hSMC with GFs showed similar results. Dermal and adventitial fibroblasts did not affect MMP-9. Elastic fiber degradation was specifically preserved by GFs via reduction of MMP-9 protein level by increasing TIMP-1 synthesis. Vascular transfer of gingival fibroblasts could be a promising approach to treat AAA.
    Arteriosclerosis Thrombosis and Vascular Biology 10/2007; 27(9):1984-90. DOI:10.1161/ATVBAHA.107.140640 · 6.00 Impact Factor
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    ABSTRACT: The main arterial pathologies can be associated with a deregulation of remodeling involving matrix metalloproteinases (MMPs), whereas gingival healing is characterized by an absence of fibrosis or irreversible elastin/collagen degradation. The aim of our study was to evaluate the effect of gingival fibroblasts on MMP-1 and MMP-3 secretion in an organotypic artery culture. MMP-1 and MMP-3 secretions and activities (dot blots, zymography, ELISA) were evaluated in coculture of rabbit artery in the presence or not of gingival fibroblasts. MMP-1/TIMP-1 and MMP-3/TIMP-1 complexes forms were measured by ELISA. Complementary studies were performed using human aortic smooth muscle cells cocultured with adventitial, dermal, or gingival fibroblasts. Our results indicated that MMP-1 and MMP-3 free-forms activities were significantly reduced in coculture. This inhibition was linked to a significant increase of TIMP-1 leading to formation of TIMP-1/MMPs complexes. Due to the presence of gingival fibroblasts, the decrease in MMP-1 and MMP-3 efficiency thus contributes to diminish the degradation of artery. This cellular therapy strategy could be promising in artery pathologies treatment.
    Connective tissue research 02/2007; 48(6):300-8. DOI:10.1080/03008200701692461 · 1.61 Impact Factor
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    ABSTRACT: Objectives: The modulation capabilities of the gingival fibroblast open new therapy strategies for vascular diseases treatment, amongst which aneurism. Cell culture media are classically supplemented with animal sera for providing cell nutriments. Unfortunately, their potential content in inter-species transmitted micro-organisms prevent from using these media for cell destined to human transplantation. This study aimed to test a synthetic and defined culture medium for human gingival fibroblasts (hGF), supplemented with human platelet lysates for rapid cell amplification. Methods: hGF proliferation was grown in a defined serum free medium (containing Invitrogen Knock-out medium) with or without platelet lysates (SF+PL and SF) and compared to the reference medium containing 10% foetal bovin serum (BSmedium). Chromosomal abnormalities were evaluated by karyotype analyses. Secretion of tissue remodelling molecules (i.e. matrix metalloproteinases, their tissue inhibitors and growth factors) and expression of several cytoskeleton markers (vimentine, actin, desmin) were also studied. Results: BSmedium and SF showed similar results in kinetics and secretions. SF+PL increased proliferation rate by a 1.5 fold without modifying other parameters. This proliferative effect is probably due to the increased levels of IL-1β, FGF-b (synthetic) and PDGF-ab. No chromosomal abnormalities were observed. Conclusions: This serum free culture medium is safe and usable for hGF culture. The protein composition is defined, and does not lead to hGF phenotype change when compared to BS medium standards. Furthermore, the addition of human platelet lysates will allow a secured faster hGF proliferation adapted for cell transplant therapy.
    Joint Meeting of the Continental European, Israeli and Scandinavian Divisions of the IADR 2009;