Alain Duhamel

CHRU de Strasbourg, Strasburg, Alsace, France

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Publications (356)1433.31 Total impact

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    ABSTRACT: Bien qu’utilisées couramment, le résultat à long terme des prothèses de genou (PTG) à contrainte augmentée (CCK) n’est pas connu avec précision. Cette série porte sur des PTG CCK au recul minimal théorique de 10 ans afin de préciser : (1) les effets secondaires (ostéolyse, descellement, faillite du mécanisme de contrainte) ; (2) le résultat fonctionnel et particulièrement la mobilité ; (3) le taux de survie.
    Revue de Chirurgie Orthopédique et Traumatologique 06/2015; 101(4). DOI:10.1016/j.rcot.2015.02.015
  • Annals of surgery 06/2015; DOI:10.1097/SLA.0000000000001312 · 7.19 Impact Factor
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    ABSTRACT: Whereas the optimal therapeutic strategy in node positive esophageal cancer primarily treated by surgery remains unknown, the study was designed to evaluate the impact of adjuvant chemotherapy on survival in such population. Among 2944 consecutive patients operated on for esophageal cancer between 2000 and 2010 in 30 European centers, patients with lymph node metastasis treated by adjuvant treatment (n = 178) were compared to patients who did not received adjuvant treatment (n = 378). Multivariable analyses and propensity score matching were used to compensate for differences in baseline characteristics. After matching, patients were comparable between the two groups. When comparing adjuvant treatment and nonadjuvant treatment groups, there was no significant differences in 3-year overall (40.9 vs. 35.8 %, P = 0.560) and disease-free (33.9 vs. 28.5 %, P = 0.190) survivals. Locoregional recurrence was lower in the adjuvant treatment group (14.4 vs. 30.9 %, P = 0.012). In the adjuvant treatment group, 94 patients received chemotherapy and 84 chemoradiotherapy, without significant survival benefit over chemoradiotherapy compared with chemotherapy alone (P = 0.280). Predictive factors of overall survival were age ≥60 years, ASA III-IV score, and pN+ classification. No survival benefit was observed according to histological subtype or occurrence of postoperative complications. Adjuvant chemo(radio)therapy did not offer survival benefit in lymph node-positive esophageal cancer patients primarily treated with surgery.
    Annals of Surgical Oncology 06/2015; DOI:10.1245/s10434-015-4658-1 · 3.94 Impact Factor
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    Congrès de l'Albatros, Paris 2015; 06/2015
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    ABSTRACT: Is intrinsic dysregulation of granulosa cells (GC) and consequent increases in the per-follicle production of anti-Müllerian hormone (AMH), correlated with the phenotypic presentation of women with polycystic ovaries? Involvement of intrinsic GC dysregulation in oligo-anovulation associated with polycystic ovary syndrome (PCOS) is likely because among women with PCOS, those with oligo-amenorrhea have higher per-follicle AMH production than those who ovulate normally, irrespective of their androgen and/or metabolic status. Women with PCOS have higher serum AMH level than non-PCOS women due to an increased follicle number and excessive AMH production per follicle, the latter reflecting a putative GC dysfunction that may vary between PCOS phenotypes. This is a retrospective analysis of data collected from 1021 women undergoing infertility evaluation from March 2011 to October 2013. The study included women with polycystic ovarian morphology (PCOM) who met the Rotterdam criteria for PCOS (n = 272), women with PCOM only (n = 168) and controls (n = 581). We used serum AMH to antral follicle count (AFC) ratio (AMH/AFC) as a marker of per-follicle AMH production and checked whether this ratio was associated with the PCOS phenotype and to the menstrual, androgen and metabolic status in women with PCOS, women with PCOM only and in controls. AMH/AFC was significantly higher in oligo-amenorrheic women with PCOS than in eumenorrheic women with PCOS or PCOM (P < 0.001) but also in the latter group compared with controls (P < 0.001) regardless of androgen status. Stepwise discriminant analysis yielded a significant score for the menstrual status with a discriminant power of 26.5% (P < 0.001). This score included AFC, AMH/AFC, waist circumference and LH with partial R(2) of 0.172, 0.042, 0.024 and 0.023, respectively. The AMH to AFC ratio as a surrogate marker for average AMH may be subject to error because follicles below the sensitivity limit of the ultrasonography used may also contribute to serum AMH concentration and secondly, AFC can be subjective. The higher AMH/AFC in women with PCOM only than in controls suggests that isolated PCOM may represent a PCOS-like phenotype in which an inherent dysfunction of GC exists but is too mild to affect the ovulatory process. No funding was obtained for this study. There are no conflicts of interest to be declared. Non-applicable. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Human Reproduction 06/2015; DOI:10.1093/humrep/dev131 · 4.59 Impact Factor
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    ABSTRACT: High-dose baclofen, i.e., 300 mg/d or more, has recently emerged as a strategy for treating alcohol dependence. The impact that the co-exposure of large amounts of alcohol and baclofen has on sedation is unclear. In a prospective cohort of 253 subjects with alcohol dependence, we collected daily alcohol and baclofen doses across the first year of baclofen treatment and the monthly maximum subjective sedation experienced by each patient (0–10 visual analog scale). For each patient-month, we determined the average weekly alcohol consumption (AWAC; standard-drinks/week) and the maximum daily dose of baclofen (DDB; mg/d). The occurrence of an episode of major sedation (EMS) during a patient-month was defined as a sedation score ≥7. The relationship between the EMS occurrence and the concurrent AWAC and DDB was investigated using a generalized estimating equation model. In total, 1528 patient-months were compiled (70 with an EMS). Univariate analyses demonstrated that the rate of patient-month to EMS increased gradually with AWAC (p<0.001), from 0.9% for AWAC=0 to 9.4% for AWAC>35. There was also a significant gradual risk for EMS associated with DDB (<0.001). Multivariate analysis demonstrated a significant interaction between DDB and AWAC on EMS risk (p=0.047). Each 20 mg/d increase in DDB was associated with an OR of EMS in AWAC>35 of 1.22 (95%CI, 1.08–1.38) versus 1.11 (95%CI, 0.96–1.29) in AWAC=1–35, and 0.95 (95%CI, 0.76–1.19) in AWAC=0. The level of sedation observed in patients using baclofen for alcohol dependence appears to directly depend on the immediate doses of both the baclofen and the alcohol.
    European Neuropsychopharmacology 06/2015; DOI:10.1016/j.euroneuro.2015.05.008 · 5.40 Impact Factor
  • La Revue de Médecine Interne 06/2015; 36:A54. DOI:10.1016/j.revmed.2015.03.289 · 1.32 Impact Factor
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    ABSTRACT: Specific immunotherapy is the only curative treatment of hymenoptera venom allergy. Currently, there is no consensus on the maintenance dose to be used. The objective of this study was to evaluate the influence of maintenance dose (100 μg versus 200 μg) on the immunologic response after 5 years of vespula venom immunotherapy.
    Revue Française d'Allergologie 05/2015; 55(4). DOI:10.1016/j.reval.2015.03.003 · 0.35 Impact Factor
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    ABSTRACT: Although constrained condylar knee (CCK) inserts are widely used for total knee arthroplasty (TKA), their long-term outcomes remain unclear. We sought to evaluate patients with at least 10 years' follow-up after CCK TKA to identify potential adverse events (osteolysis, loosening, constraint-mechanism failure), assess functional outcomes with special emphasis on range of motion, and determine prosthesis survival. Increasing constraint by implantation of a CCK insert does not increase the long-term frequencies of osteolysis or mechanical loosening. We studied 43 knees after Legacy(®) CCK TKA. The indication was severe deformity (n=20), pre-operative laxity (n=6), or failure to achieve intra-operative balancing (n=17). There were 41 patients with a mean age of 66 years (21-88). A history of one or more surgical procedures was noted for 27 (63%) knees. Outcome measures were the Hospital for Special Surgery (HSS) knee score, Knee Society Score (KSS), and change in the hip-knee-ankle (HKA) angle. Prosthesis survival was assessed using revision surgery for any reason or for reasons other than infection as the censoring criterion. Complications other than venous thrombosis occurred in 16% of patients, including 3 who required revision surgery (septic loosening, n=2; and major instability in a patient with ipsilateral hip arthrodesis). No cases of osteolysis or aseptic loosening were recorded. Mean follow-up was 12.7 years (range, 10-14). At last follow-up, the HSS score had improved from 53 (26-83) pre-operatively to 80 (55-93), the KSS knee component from 42 (16-77) to 90 (77-99), and the KSS function component from 31 (0-80) to 61 (10-90) (P<0.001). Mean range of flexion increased from 109° (50°-140°) to 112° (90°-130°) (P=0.12). The HKA angle changed from 182°±15.5° (150°-210°) to 179.5°±2.5° (174°-184°) (P=0.5). The 11-year prosthesis survival rate was 88.5% (95% confidence interval, 0.69-0.94) overall and 97.7% (0.76-0.99) after excluding the cases of infection. Long-term functional gains after CCK TKA were similar to those reported after standard posterior-stabilised TKA, with no cases of constraint-mechanism failure or osteolysis. The complication rate was higher, with decreased survival compared to standard TKA, but the knee deformities and/or instability were particularly severe and two-thirds of knees had a history of one or more surgical procedures. Level IV, retrospective case-series study. Copyright © 2015. Published by Elsevier Masson SAS.
    Orthopaedics & Traumatology Surgery & Research 05/2015; 101(4). DOI:10.1016/j.otsr.2015.01.020 · 1.17 Impact Factor
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    ABSTRACT: & Aims: Several models have been used to determine prognoses of patients with alcoholic hepatitis. These include static systems (the Maddrey discriminant function; the age, bilirubin, international normalized ratio, creatinine [ABIC] score; and model for end-stage liver disease [MELD] score) and dynamic models (the Lille model). We aimed to combine features of all these models to develop a better method to predict outcomes of patients with alcoholic hepatitis. We collected data from several databases of patients with severe alcoholic hepatitis treated with corticosteroids in France and the UK to create a model to predict patient survival (derivation cohort, n=538 patients). We compared the performances of 3 joint-effect models (Maddrey+Lille, MELD+Lille, ABIC+Lille) to determine which combination had the best prognostic value, based on known patient outcomes. The model was validated using data from trials of the effects of corticosteroids in patients in the US, France, Korea, and Belgium (n=604 patients). We created a joint-effect model to predict patient survival after 2 and 6 months; in the derivation and validation cohorts, it predicted outcome significantly better than either static or dynamic models alone (P<.01 for all comparisons). The joint model accurately predicted patient survival regardless of patient risk level. The MELD+Lille combination was better than the Maddrey+Lille or ABIC+Lille in predicting patient survival, with Akaike information criterion values of 1305, 1313, and 1312 respectively. For example, based on the MELD+Lille combination model, predicted 6-month mortality of complete responders with MELD scores of 15-45 (Lille score 0.16) was 8.5% to 49.7%, compared with 16.4%-75.2% for non-responders (Lille score 0.45). According to the joint-effect model, for 2 patients with the same baseline MELD score of 21, the patient with a Lille score of 0.45 had a 1.9-fold higher risk of death than the patient with a Lille score of 0.16 (23.7% vs 12.5%). By combining results from static and dynamic scoring systems for liver disease, we can better predict outcomes of patients with alcoholic hepatitis, compared with either model alone. This may help patient management and design of clinical trials. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
    Gastroenterology 04/2015; DOI:10.1053/j.gastro.2015.04.044 · 13.93 Impact Factor
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    ABSTRACT: The provision of informed consent is a prerequisite for inclusion of a patient in a clinical research project. In some countries, the legislation on clinical research authorizes a third person to provide informed consent if the patient is unable to do so directly (i.e. surrogate consent). This is the case during acute stroke, when the symptoms may prevent the patient from providing informed consent and thus require a third party to be approached. Identification of factors associated with the medical team's decision to resort to surrogate consent may (i) help the care team during the inclusion process and (ii) enable the patient's family circle to be better informed (and thus feel less guilty) about providing surrogate consent. Patients included in the BIOSTROKE cohort (initially dedicated to the analysis of factors influencing stroke severity) were divided into two groups: those having provided informed consent directly and those for whom a third party (such as a family member) had provided surrogate consent. We compared the groups in terms of the initial clinical characteristics (age, gender, type of stroke, severity on the National Institutes of Health Stroke Scale (NIHSS), pre-stroke cognitive status according to the Informant Questionnaire on Cognitive Decline in the Elderly, and the stroke's aetiology) and the functional and cognitive impairments (according to the NIHSS, the modified Rankin score (mRS) and the Mini Mental State Examination) on post-stroke days 8 and 90. Three hundred and ninety five patients were included (mean ± SD age: 67 ± 15 years; 53% males). Surrogate consent had been obtained in 228 cases, and 167 patients had provided consent themselves. The patients included with surrogate consent were likely to be older and more aphasic, with a pre-existing cognitive disorder and more severe stroke (relative to the patients having provided consent). In terms of recovery, the patients included with surrogate consent had a worse functional prognosis (day 90 mRS ≥3: 57.6%, compared with 16.8% in patients having provided consent themselves; p < 0.0001) and a worse cognitive prognosis (day 90 MMS < 24: 15.4% and 4.8%, respectively; p < 0.002). The mortality rate was significantly higher in the surrogate consent group. We found that in addition to age, aphasia and stroke severity, pre-stroke cognitive status is a factor that should prompt the care team to consider requesting surrogate consent for participation in a clinical study. Given that the unfavourable outcome in patients with surrogate consent is often due to their initial clinical state (rather than inclusion in a trial per se), the issue of the family's feelings of guilt (and how to avoid these feelings) should be further addressed.
    BMC Medical Ethics 04/2015; 16(1):26. DOI:10.1186/s12910-015-0018-8 · 1.60 Impact Factor
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    ABSTRACT: & Aims: The effects of bariatric surgery in patients with non-alcoholic fatty liver disease (NASH) are not well established. We performed a prospective study to determine the biologic and clinical effects of bariatric surgery in patients with NASH. From May 1994 through May 2013,109 morbidly obese patients with biopsy-proven NASH underwent bariatric surgery at the University Hospital of Lille, France (the Lille Bariatric Cohort). Clinical, biologic, and histologic data were collected before and 1 year after surgery. One year after surgery, NASH had disappeared from 85% of the patients (95% confidence interval [CI], 75.8%-92.2%). Compared with before surgery, patients had significant reductions in mean body mass index (BMI, from 49.3±8.2 to 37.4±7) and level of alanine aminotransferase (from 52.1±25.7 to 25.1±20); mean levels of glutamyl transferases were reduced from 51 before surgery (interquartile range [IQR], 34-87) to 23 afterward (interquartile range, 14-33) and mean insulin resistance index values were reduced from 3.6±0.5 to 2.9±0.5 (P<.01 for each comparison). NASH disappeared from a higher proportion of patients with mild NASH before surgery (94%) than severe NASH (70%) (P<.05), according to Brunt score. In histologic analysis, steatosis was detected in 60% of the tissue before surgery (IQR, 40%-80%) but only 10% 1 y after surgery (IQR, 2.5%-21.3%); the mean non-alcoholic fatty liver diseases score was reduced from 5 (IQR, 4-5) to 1 (IQR, 1-2) (each P<.001). Hepatocellular ballooning was reduced in 84.2% of samples (n=69; 95% CI, 74.4-91.3) and lobular inflammation in 67.1% (n=55; 95% CI, 55.8-77.1). According to Metavir scores, fibrosis was reduced in 33.8% of patients (95% CI, 23.6%-45.2%). Patients whose NASH persisted 1 y after surgery (n=12) had lost significantly less weight (change in BMI, 9.1±1.5 kg/m(2)) than those without NASH (change in BMI, 12.3±0.6 kg/m(2)) (P=.005). Patients who underwent laparoscopic gastric banding lost less weight (6.4±0.7 kg/m(2)) than those who underwent gastric bypass (14.0±0.5 kg/m(2)) (P<.0001), and a higher proportion had persistent NASH (30.4% vs 7.6% of those with gastric bypass; P=.015). Bariatric surgery induced the disappearance of NASH from nearly 85% of patients and reduced the pathologic features of the disease, after 1 y of follow up. It could be a therapeutic option for appropriate, morbidly obese patients with NASH who do not respond to lifestyle modifications. More studies are needed to determine the long-term effects of bariatric surgery in morbidly obese patients with NASH. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
    Gastroenterology 04/2015; DOI:10.1053/j.gastro.2015.04.014 · 13.93 Impact Factor
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    ABSTRACT: Due to its high prevalence in dual-task paradigms, freezing of gait in Parkinson's disease is thought to be associated with dysexecutive syndrome and attentional disorders. However, the role of specific attentional disorders in patients with freezing of gait is still unclear. Here, we sought to specifically determine which basic attentional modalities are impaired in patients with freezing of gait. Seventy-eight parkinsonian patients performed a computer-controlled reaction-time paradigm designed to measure the different attentional subcomponents, controlled for visuospatial processing and motor participation. The freezer (n = 42) and non-freezer (n = 36) groups were matched for age, educational level, MMSE and MDRS. There were no intergroup differences in simple reaction times, whereas choice reaction times were higher in the freezer group than in the non-freezer group for divided attention (p = 0.023). At equivalent levels of overall cognitive efficiency, freezer patients showed a greater slowdown than non-freezer patients with a specific impairment in divided attention.
    04/2015; 5(2). DOI:10.3233/JPD-140498
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    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 04/2015; DOI:10.1016/j.jgyn.2015.02.018 · 0.62 Impact Factor
  • Journal of Hepatology 04/2015; 62:S757-S758. DOI:10.1016/S0168-8278(15)31285-X · 10.40 Impact Factor
  • Gastroenterology 04/2015; 148(4):S-39. DOI:10.1016/S0016-5085(15)30135-9 · 13.93 Impact Factor
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    ABSTRACT: Based on theoretical evidence, intensity at the crossover point (COP) of substrate utilization could be considered as potential exercise intensity for metabolic syndrome (MetS). This study aimed to examine the effects of a training program at COP on exercise capacity parameters in women with MetS and to compare two metabolic indices (COP and the maximal fat oxidation rate point LIPOXmax®) with ventilatory threshold (VT). Nineteen women with MetS volunteered to perform a 12-week training program on cycle ergometer, with an intensity corresponding to COP. Pre- and post-training values of anthropometric and exercise capacity parameters were compared in order to determine the effects of exercise training. The pre-post training change of COP, LIPOXmax® and VT were also investigated. After training, anthropometric parameters were significantly modified, with a reduction of body mass (3.0 ± 3.0%, p<0.001), fat mass (3.3 ± 3.4%, p<0.001) and body mass index (3.2 ± 3.4%, p<0.001). Exercise capacity was improved after the training program, with significant increase of maximal power output (25.0 ± 18.4%, p<0.001) and maximal oxygen uptake (VO2max = 9.0 ± 11.2%, p<0.01). Lastly, when expressed in terms of power output, COP, LIPOXmax® and VT occurred at a similar exercise intensity but the occurrence of these three indices is different when expressed in terms of oxygen uptake, heart rate or rating of perceived exertion. This study highlights the effectiveness of 12-week training program at COP to improve physical fitness in women with MetS. The relationships between metabolic indices and VT in terms of power output highlight the determination of VT from a shorter maximal exercise as a useful method for the determination of metabolic indices in MetS.
    Medicine and science in sports and exercise 03/2015; DOI:10.1249/MSS.0000000000000674 · 4.46 Impact Factor
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    ABSTRACT: After more than 50 years of treating Parkinson's disease with l-DOPA, there are still no guidelines on setting the optimal dose for a given patient. The dopamine transporter type 1, now known as solute carrier family 6 (neurotransmitter transporter), member 3 (SLC6A3) is the most powerful determinant of dopamine neurotransmission and might therefore influence the treatment response. We recently demonstrated that methylphenidate (a dopamine transporter inhibitor) is effective in patients with Parkinson's disease with motor and gait disorders. The objective of the present study was to determine whether genetic variants of the dopamine transporter type 1-encoding gene (SLC6A3) are associated with differences in the response to treatment of motor symptoms and gait disorders with l-DOPA and methylphenidate (with respect to the demographic, the disease and the treatment parameters and the other genes involved in the dopaminergic neurotransmission). This analysis was part of a multicentre, parallel-group, double-blind, placebo-controlled, randomized clinical trial of methylphenidate in Parkinson's disease (Protocol ID:2008-005801-20; ClinicalTrials.gov:NCT00914095). We scored the motor Unified Parkinson's Disease Rating Scale and the Stand-Walk-Sit Test before and after a standardized acute l-DOPA challenge before randomization and then after 3 months of methylphenidate treatment. Patients were screened for variants of genes involved in dopamine metabolism: rs28363170 and rs3836790 polymorphisms in the SLC6A3 gene, rs921451 and rs3837091 in the DDC gene (encoding the aromatic L-amino acid decarboxylase involved in the synthesis of dopamine from l-DOPA), rs1799836 in the MAOB gene (coding for monoamine oxidase B) and rs4680 in the COMT gene (coding for catechol-O-methyltransferase). Investigators and patients were blinded to the genotyping data throughout the study. Eighty-one subjects were genotyped and 61 were analysed for their acute motor response to l-DOPA. The SLC6A3 variants were significantly associated with greater efficacy of l-DOPA for motor symptoms. The SLC6A3 variants were also associated with greater efficacy of methylphenidate for motor symptoms and gait disorders in the ON l-DOPA condition. The difference between motor Unified Parkinson's Disease Rating Scale scores for patients with different SLC6A3 genotypes was statistically significant in a multivariate analysis that took account of other disease-related, treatment-related and pharmacogenetic parameters. Our preliminary results suggest that variants of SLC6A3 are genetic modifiers of the treatment response to l-DOPA and methylphenidate in Parkinson's disease. Further studies are required to assess the possible value of these genotypes for (i) guiding l-DOPA dose adaptations over the long term; and (ii) establishing the risk/benefit balance associated with methylphenidate treatment for gait disorders. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Brain 03/2015; DOI:10.1093/brain/awv063 · 10.23 Impact Factor
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    ABSTRACT: The objectives of the present study were to (i) better characterize visual emotional experience in patients with temporal lobe epilepsy (TLE), (ii) identify clinical risk factors that might be predictive of a change in emotional experience, and (iii) study the relationships between emotional experience and psychobehavioral/quality-of-life factors. Fifty patients with TLE and fifty matched controls evaluated the emotional content of unpleasant, pleasant, and neutral pictures with respect to their valence (unpleasant-to-pleasant) and arousal (low-to-high) levels. Demographic, cognitive, and psychobehavioral data were recorded for all participants, and clinical data and factors related to quality of life were also collected for patients with TLE. There were no significant differences between the group with TLE and the control group in terms of valence evaluations. However, arousal scores for neutral pictures were significantly higher in patients with TLE than in controls. There was also a nonsignificant trend towards lower arousal scores for pleasant pictures in patients with TLE than in controls. Although none of the recorded clinical factors were found to be related to emotional experience, the level of apathy was predictive of greater arousal experience for neutral pictures in patients with TLE. In conclusion, emotional experience appears to be modified in TLE and might be related to apathy. Changes in emotional experience should be taken into account in studies in which neutral stimuli are used to establish a baseline level when assessing emotional and cognitive processing. Copyright © 2015 Elsevier Inc. All rights reserved.
    Epilepsy & Behavior 03/2015; 45:15-20. DOI:10.1016/j.yebeh.2015.02.005 · 2.06 Impact Factor
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    ABSTRACT: The prognosis of myelodysplastic syndromes (MDS) after allogeneic stem cell transplantation is critically determined by cytogenetic abnormalities, as previously defined by International Prognostic Scoring System (IPSS) cytogenetics. It has been shown that a new cytogenetic classification, included in the IPSS-R (cytogenetic-IPSS-R [C-IPSS-R]), can better predict the outcome of untreated MDS patients. In this study, we assessed the impact of the IPSS-R cytogenetic score (C-IPSS-R) on the outcome of 367 MDS patients transplanted from HLA-identical siblings or HLA allele-matched unrelated donors. According to the C-IPSS-R, 178 patients (48%) fell in the good risk, 102 (28%) in the intermediate risk, 77 (21%) in the poor risk, and 10 (3%) in the very poor risk group. In multivariate analysis, after a median follow-up of 4 years, the poor and very poor-risk categories correlated with shorter overall survival (OS) (4-year OS, 32%; hazard ratio [HR], 1.59; P = 0.009 and OS, 10%; HR, 3.18; P = 0.002, respectively) and higher cumulative incidence of relapse (CIR) (CIR, 52%; HR, 1.82; P = 0.004 and CIR, 60%; HR, 2.44; P = 0.060, respectively). Overall, the C-IPSS-R changed the IPSS cytogenetic risk only in 8% of cases but identified a new risk group, the very poor C-IPSS-R category, with dismal outcome after allogeneic stem cell transplantation (10% 4-year OS, 60% 4-year CIR). Posttransplantation maintenance therapy should be investigated in prospective trials for patients with high-risk C-IPSS-R karyotypes.
    Transplantation 03/2015; DOI:10.1097/TP.0000000000000649 · 3.78 Impact Factor

Publication Stats

5k Citations
1,433.31 Total Impact Points

Institutions

  • 2001–2015
    • CHRU de Strasbourg
      Strasburg, Alsace, France
    • Université du Droit et de la Santé Lille 2
      • Faculty of Medicine
      Lille, Nord-Pas-de-Calais, France
  • 2000–2015
    • Lille Catholic University
      Lille, Nord-Pas-de-Calais, France
  • 1999–2015
    • Centre Hospitalier Régional Universitaire de Lille
      • Division of Neurology
      Lille, Nord-Pas-de-Calais, France
  • 1997–2015
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France