Corinne Alberti

Unité Inserm U1077, Caen, Lower Normandy, France

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Publications (207)883.51 Total impact

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    ABSTRACT: Objectives To shed light on the meaning of Aspergillus-positive lower-respiratory-tract samples in non immunocompromized critically ill patients. Methods Multicentre matched case-control (1:5) study. We used prospectively collected data to identify risk factors for Aspergillus-positive specimens, as well as outcomes in Aspergillus-positive patients. Results 66 cases (5 with definite invasive pulmonary aspergillosis (IPA), 18 with probable IPA, and 43 colonisations) were matched to 330 controls. In the multivariate conditional logistic model, independent risk factors for at least one Aspergillus-positive respiratory-tract specimen were worse SAPSII at admission [OR, 1.10; 95%CI, 1.00-1.21], ARDS [OR, 2.64; 95%CI, 1.29-5.40]; long-term steroid therapy [OR, 4.77; 95%CI, 1.49-15.23]; steroid therapy started in the ICU [OR, 11.03; 95%CI, 4.40-27.67]; and bacterial infection [OR, 2.73; 95%CI, 1.37-5.42]. The risk of death, compared to the controls, was not higher in the cases overall [HR, 0.66; 95%CI, 0.41-1.08; p=0.1] or in the subgroups with definite IPA [HR, 1.60; 95%CI, 0.43-5.94; p=0.48], probable IPA [HR, 0.84; 95%CI, 0.28-2.50; p=0.76], or colonisation [HR, 0.58; 95%CI, 0.33-1.02; p=0.06]. In cases who received antifungal therapy, mortality was not lower than in untreated cases [HR, 0.67; 95%CI, 0.36-1.24; p=0.20]. Conclusions In critically ill immunocompetent patients, risk factors for presence of Aspergillus in lower respiratory tract specimens are steroid therapy (either chronic or initiated in the ICU), ARDS, and high severity of the acute illness. Prospective studies are warranted to further examine these risk factors and to investigate immune functions as well as the impact of antifungal therapy on patient outcomes.
    Journal of Infection 09/2014; · 4.07 Impact Factor
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    ABSTRACT: To evaluate the frequency and to identify the risk factors of severe perineal lacerations and the subgroup of women exposed to the highest risk for these complications.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 08/2014; 182C:11-15. · 1.84 Impact Factor
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    ABSTRACT: Background: Perinatal lung growth is highly vulnerable to inflammation and intrauterine growth restriction (IUGR), two major risk factors for chronic lung disease (CLD) in preterm neonates. However, the balance between extremely low gestational age (ELGA) and IUGR in very preterm infants as risk factors for CLD and co-morbidities remains poorly explored. Objectives: This single-center study aims to compare neonatal morbidity (including CLD) and mortality among ELGA infants with normal birth weight (ELGA-AGA), very preterm infants with IUGR <3rd percentile (VLGA-IUGR) and very preterm infants with a birth weight appropriate for gestational age (VLGA-AGA), matched with VLGA-IUGR infants. Methods: Selected characteristics of the perinatal and neonatal periods were recorded and retrospectively compared among the three groups. Infants with major congenital anomalies were excluded. The diagnosis of CLD was based on whether the infant was receiving supplemental oxygen and/or non-invasive ventilation at a postmenstrual age of 36 weeks. Results: We found that, despite a median difference of 3 weeks in gestational age at birth between VLGA-IUGR and ELGA-AGA infants, neonatal mortality was 35% higher in neonates who had experienced fetal growth restriction, and that VLGA- IUGR was five times more predictive of CLD than was ELGA-AGA. These differences persisted after adjustment for confounding factors such as antenatal steroids, gender and respiratory distress syndrome. Conclusions: This study reports that VLGA-IUGR infants are at higher risk of neonatal mortality and CLD than both ELGA-AGA and VLGA-AGA infants. © 2014 S. Karger AG, Basel.
    Neonatology 08/2014; 106(4):304-310. · 2.57 Impact Factor
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    ABSTRACT: Infants with Noonan syndrome (NS) are predisposed to developing juvenile myelomonocytic leukaemia (JMML) or JMML-like myeloproliferative disorders (MPD). Whereas sporadic JMML is known to be aggressive, JMML occurring in patients with NS is often considered as benign and transitory. However, little information is available regarding the occurrence and characteristics of JMML in NS.
    Journal of Medical Genetics 08/2014; · 5.70 Impact Factor
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    ABSTRACT: In this clinical trial, we aimed to compare three means of performing chronic hemodialysis in patients with contra-indication to systemic heparinization. This open-label monocentric randomized « n-of-one » trial, conducted in a single tertiary care center, recruited chronic hemodialysis patients with a contra-indication to systemic heparinization for at least 3 consecutive sessions. All patients underwent hemodialysis with an AN69ST dialyzer, and were administered three alternative dialysis procedures in a random sequence: intermittent saline flushes, constant saline infusion, or pre-dialysis heparin coating of the membrane. The primary outcome was the need to interrupt the dialysis session because of clotting events due to either (i) a complete coagulation of the circuit; (ii) a partial coagulation of the circuit; (iii) a>50% rise over baseline in the venous pressure. At the end of the inclusion period (May, 2007 to December, 2008), the number of patients to include (n = 75) was not reached: only 46 patients were included and underwent randomization. The study was terminated, and statistical analysis took into account 224 hemodialysis sessions performed in 44 patients with analyzable data. Heparin adsorption was associated with a significant reduction of the need to interrupt the dialysis session because of clotting events: odds ratio 0.3 (CI 95% 0.2 to 0.6; p<0.001, versus intermittent saline flushes). Heparin adsorption was also associated with higher odds for performing >3 h dialysis sessions and for having complete blood restitution. There were no significant effects of the dialysis procedure on weight loss, online ionic dialysance, and adverse events. Heparin-coated AN69ST dialysis membrane is a safe and effective method to avoid or delay per-dialytic clotting events in patients with contra-indication to systemic anticoagulation. However, results are not generalizable safely to patients with active bleeding, since weak heparinemia, not assessed in this study, may occur. NCT00473109.
    PLoS ONE 05/2014; 9(5):e97187. · 3.53 Impact Factor
  • Journal of clinical epidemiology 04/2014; · 5.48 Impact Factor
  • Corinne Alberti, Rym Boulkedid
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    ABSTRACT: The purpose of a scientific paper is to communicate results and within the paper this applies especially to the presentation of data. It is the universal practice in medical journals to present statistical results using tables. Good tables are an integral part of the manuscript. To help researchers communicate their results, we present practical guidance for reporting statistical results using tables. Five key points are presented for reporting statistical results using tables: (1) early reflection and choice about the results to present, (2) presentation of tables and definition of rows and columns, (3) filling the cells, (4) title, caption, footnotes, and quality, (5) final checklist. This guidance is a practical tool to improve the reporting of statistical results using tables when presenting ICU data in future research.
    European Journal of Intensive Care Medicine 03/2014; · 5.17 Impact Factor
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    ABSTRACT: Graves' disease is an autoimmune disorder resulting from thyrotropin receptor stimulation by autoantibodies. It may occur at any age during childhood, but its frequency increases with age, peaking during adolescence. Symptoms and signs are often recognizable and proportional to the increase in serum free thyroid hormone levels. Antithyroid drug treatment with methimazole (or carbimazole) is recommended for initial treatment, but relapse rates are high, with remission achieved in only 30% of children after a first course of treatment for about two years. More prolonged medical treatment may increase the remission rate to up to 50%. Alternative treatments, such as radioactive iodine or thyroidectomy, are considered in cases of relapse, lack of compliance or antithyroid drug toxicity. Relapse risk decreases with increasing duration of the first course of antithyroid drug treatment. The identification of other predictive factors, such as severe biochemical hyperthyroidism at diagnosis, young age and the absence of other autoimmune conditions, has made it possible to stratify patients according to the risk of relapse, leading to improvements in patient management, by facilitating the identification of patients requiring long-term antithyroid drug treatment or early alternative therapy.
    Best practice & research. Clinical endocrinology & metabolism. 03/2014; 28(2):233-243.
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    ABSTRACT: The prevention of neurological disabilities following preterm birth remains a major public health challenge and efforts are still needed to test the neuroprotective properties of candidate molecules. Melatonin serves as a neuroprotectant in adult models of cerebral ischemia through its potent antioxidant and anti-inflammatory effects. An increasing number of preclinical studies have consistently demonstrated that melatonin protects the damaged developing brain by preventing abnormal myelination and an inflammatory glial reaction, a major cause of white matter injury. The main questions asked in this review are whether preclinical data on the neuroprotective properties of melatonin are sufficient to translate this concept into the clinical setting, and whether melatonin can reduce white matter damage in preterm infants. This review provides support for our view that melatonin is now ready to be tested in human preterm neonates, and discusses ongoing and planned clinical trials.
    Developmental Medicine & Child Neurology 02/2014; · 2.68 Impact Factor
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    ABSTRACT: Electronic Case Report Forms (eCRFs) are increasingly chosen by investigators and sponsors of clinical research instead of the traditional pen-and-paper data collection (pCRFs). Previous studies suggested that eCRFs avoided mistakes, shortened the duration of clinical studies and reduced data collection costs. Our objectives were to describe and contrast both objective and subjective efficiency of pCRF and eCRF use in clinical studies. A total of 27 studies (11 eCRF, 16 pCRF) sponsored by the Paris hospital consortium, conducted and completed between 2001 and 2011 were included. Questionnaires were emailed to investigators of those studies, as well as clinical research associates and data managers working in Paris hospitals, soliciting their level of satisfaction and preferences for eCRFs and pCRFs. Mean costs and timeframes were compared using bootstrap methods, linear and logistic regression. The total cost per patient was 374[euro sign] +/-351 with eCRFs vs. 1,135[euro sign] +/-1,234 with pCRFs. Time between the opening of the first center and the database lock was 31.7 months Q1 = 24.6; Q3 = 42.8 using eCRFs, vs. 39.8 months Q1 = 31.7; Q3 = 52.2 with pCRFs (p = 0.11). Electronic CRFs were globally preferred by all (31/72 vs. 15/72 for paper) for easier monitoring and improved data quality. This study found that eCRFs and pCRFs are used in studies with different patient numbers, center numbers and risk. The first ones are more advantageous in large, low-risk studies and gain support from a majority of stakeholders.
    BMC Medical Research Methodology 01/2014; 14(1):7. · 2.21 Impact Factor
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    ABSTRACT: Objectif En 2011, de nouvelles recommandations sur les prescriptions d’antibiotiques en cas d’otites moyennes aiguës (OMA) ont été publiées visant à réduire les prescriptions de céphalosporine de 3e génération qui favorisent le portage d’Escherichia coli producteur de ß-lactamase à spectre étendu. L’objectif de l’étude était d’évaluer l’impact des recommandations 2011 sur le type d’antibiotiques prescrits en cas d’OMA. Méthodes Entre le 1er novembre 2009 et le 31 octobre 2012, 14 661 enfants âgés de 6 à 24 mois avec un diagnostic d’OMA ont été inclus dans deux études : l’une réalisée grâce au concours de 62 pédiatres libéraux et l’autre dans 7 services d’urgences pédiatriques. Trois périodes de 1 an chacune ont été définies. Résultats Des antibiotiques ont été prescrits dans 12 471 (85,1 %) des cas. La part de l’amoxicilline a été multipliée par 25 entre la première année (2,6 %) et la dernière année (66,1 %). À l’inverse, les prescriptions de cefpodoxime proxétil et d’amoxicilline-acide clavulanique ont diminué passant respectivement de 33,6 % et 62,0 % la première année à 5,2 % et 27,7 % la dernière année. Cette évolution a été constatée tant chez les pédiatres libéraux que dans les services d’urgences pédiatriques. Conclusion Conformément aux recommandations françaises de 2011, l’amoxicilline est devenue en 2012 le premier antibiotique prescrit en cas d’OMA tandis que la part des antibiotiques à large spectre s’est réduite. Notre étude souligne l’importance de la publication de recommandations pour lutter contre la prescription d’antibiotiques à large spectre, facteur crucial dans la lutte contre la résistance bactérienne aux antibiotiques.
    Médecine et Maladies Infectieuses 01/2014; · 0.75 Impact Factor
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    ABSTRACT: Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to develop a screening tool to identify omissions and inappropriate prescriptions in pediatrics based on French and international guidelines.
    PLoS ONE 01/2014; 9(6):e101171. · 3.53 Impact Factor
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    ABSTRACT: To determine the reproducibility, the inter-hemispheric difference and the reference ADC values of the fetal brain according to gestational age. 101 normal fetal brain (29.4 to 38.4 weeks) were analysed with DWI. ADC was measured in frontal (FWM), occipital white matter (OWM), Centrum Semi Ovale (CSO), basal ganglia (BG), cerebellar hemisphere (CBM) and pons. ADC ratio (fronto-occipital, fronto-cerebellar and occipito-cerebellar) were calculated. Inter-observer reproducibility was assessed on 27 studies, using intra-class correlation coefficient (ICC) and Bland-Altman plot. Inter-hemispheric difference was evaluated with Bland-Altman plot. Gestation-specific reference intervals were estimated for each brain region. Inter-observer bias was near zero. Limits of agreement (LOA) were clinically acceptable (-0.17; 0.20 to -0.38; 0.31 x10-3 mm2/s) for all brain regions except for CSO and pons.Inter-hemispheric bias was near zero. Smallest LOA were for FWM (± 0.09 mm2/s) and BG (± 0.019 mm2/s). ADC values decreased, whereas ADC ratio increased with gestational age, reflecting normal maturation. Fronto-occipital, fronto-cerebellar and occipito-cerebellar ratios were consistently above 0.8, 1 and 1 respectively. The fetal brain regions with the highest reproducibility and smallest interhemispheric differences are the frontal, occipital, cerebellar white matter and basal ganglia. ADC ratio could be useful to assess differential temporo-spatial maturation. This article is protected by copyright. All rights reserved.
    Prenatal Diagnosis 12/2013; · 2.68 Impact Factor
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    ABSTRACT: Abstract Objective: The aim of the present study was to determine specific obstetrical and neonatal complications associated with diet-treated gestational diabetes (DTGD) and medically treated gestational diabetes (MTGD). Methods: This is a prospective cohort study of women followed in the Robert Debré Hospital (France, Paris) and who have given birth between 1 January, 2004, and 19 November, 2010. Clinical, biological, maternal and neonatal data were reported in the maternity database. Associations between obstetrical and neonatal complications and gestational diabetes were evaluated by estimating odd ratios (ORs) and their 95% CIs, using a logistic regression model. Results: 16,244 pregnancies were included in the study. 1515 (9.3%) women had gestational diabetes: 1108 (7.3%) had DTGD, 243 (1.7%) had MTGD. After full adjustment, MTGD was associated with an increased risk of nonscheduled cesarean (ORnonscheduled=2.3; 95% CI: 1.6-3.3; P<0.001) while DTGD was not (ORnonscheduled=1.0; 95% CI: 0.8-1.3; P<0.96). Clinical macrosomia was positively associated with DTGD (OR=2; 95% CI: 1.7-2.4; P<0.0001) or MTGD (OR=2.9; 95% CI: 2.1-3.9; P<0.0001). Conclusion: This study confirms that macrosomia is the main complication of DTGD. By contrast, DTGD was not associated with neonatal hypoglycemia and cesarean, while these complications were associated with MTGD.
    Journal of Perinatal Medicine 11/2013; · 1.95 Impact Factor
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    ABSTRACT: From November 2009 to October 2012, implementation of guidelines, unlabeled by the French Agency of Health Products, changed the categories of antibiotics prescribed for acute respiratory tract infections (ARTI) in seven pediatric emergency departments. During the study, 36,413 ARTI-related antibiotic prescriptions were prescribed. Amoxicillin prescriptions rose from 30.0% to 84.7%, while amoxicillin-clavulanate and cefpodoxime prescriptions decreased to 10.2% and 2.5%, respectively.
    The Pediatric Infectious Disease Journal 10/2013; · 3.57 Impact Factor
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    ABSTRACT: In patients with sickle cell anaemia (SCA), concomitant glucose-6-phosphate dehydrogenase (G6PD) deficiency is usually described as having no effect and only occasionally as increasing severity. We analysed sequential clinical and biological data for the first 42 months of life in SCA patients diagnosed by neonatal screening, including 27 G6PD-deficient patients, who were matched on sex, age and parents' geographic origin to 81 randomly selected patients with normal G6PD activity. In the G6PD-deficient group, steady-state haemoglobin was lower (-6·2 g/l, 95% confidence interval (CI), [-10·1; -2·3]) and reticulocyte count higher (247 × 10(9) /l, 95%CI, [97; 397]). The acute anaemic event rate was 3 times higher in the G6PD-deficient group (P < 10(-3) ). A higher proportion of G6PD-deficient patients required blood transfusion (20/27 [74%] vs. 37/81 [46%], P < 10(-3) ), for acute anaemic events, and also vaso-occlusive and infectious events. No significant between-group differences were found regarding the rates of vaso-occlusive, infectious, or cerebrovascular events. G6PD deficiency in babies with SCA worsens anaemia and increases blood transfusion requirements in the first years of life. These effects decrease after 2 years of age, presumably as the decline in fetal haemoglobin levels leads to increased sickle cell haemolysis and younger red blood cells with higher G6PD activity.
    British Journal of Haematology 10/2013; · 4.94 Impact Factor
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    ABSTRACT: Little is known about the socioprofessional situation of adult-aged kidney-transplanted children. This nationwide French cohort study documented the socioprofessional outcomes of adults who underwent kidney transplantation before age 16 years between 1985 and 2002. Of 890 patients, 624 were eligible for a questionnaire and 374 completed it (response rate=60%; men=193 and women=181). The data were compared with the French general population using an indirect standardization matched for gender, age, and period. The median ages were 27.1 years at survey time and 12.3 years at first transplantation. Of the participants, 31.1% lived with a partner (vs. 52.2%; P<0.01) and 35.7% lived with their parents (vs. 21.0%; P<0.01). When standardized for parental educational level, fewer participants had a high-level degree (≥3-year university level) and fewer women had a baccalaureate degree. Professional occupations were similar to the French general population, but unemployment was higher (18.5% vs. 10.4%; P<0.01). Independent predictive factors for poor socioprofessional outcome were primary disease severity (onset in infancy or hereditary disease), the presence of comorbidities or sensorial disabilities, low educational level of the patient or his parents, female gender, and being on dialysis after graft failure. Transplanted children, particularly girls and patients with low parental educational levels, require optimized educational, psychologic, and social support to reach the educational level of their peers. This support should be maintained during adulthood to help them integrate into the working population and build a family.
    Transplantation 10/2013; · 3.78 Impact Factor
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    ABSTRACT: High-dose steroid therapy has been proven effective in AIDS-related Pneumocystis pneumonia (PCP) but not in non-AIDS-related cases. We evaluated the effects on survival of steroids in HIV-negative patients with PCP. Retrospective study patients admitted to the ICU with hypoxemic PCP. We compared patients receiving HDS (>=1 mg/Kg/day prednisone equivalent), low-dose steroids (LDS group, <1 mg/Kg/day prednisone equivalent), and no steroids (NS group). Variables independently associated with ICU mortality were identified. 139 HIV-negative patients with PCP were included. Median age was 48 [40--60] years. The main underlying conditions were hematological malignancies (n=55, 39.6%), cancer (n=11, 7.9%), and solid organ transplantation (n=73, 52.2%). ICU mortality was 26% (36 deaths). The HDS group had 72 (51.8%) patients, the LDS group 35 (25%) patients, and the NS group 32 (23%) patients. Independent predictors of ICU mortality were SAPS II at ICU admission (odds ratio [OR], 1.04/point; [95%CI], 1.01-1.08, P=0.01), non-hematological disease (OR, 4.06; [95%CI], 1.19-13.09, P=0.03), vasopressor use (OR, 20.31; 95%CI, 6.45-63.9, P<0.001), and HDS (OR, 9.33; 95%CI, 1.97-44.3, P=0.02). HDS was not associated with the rate of ICU-acquired infections. HDS were associated with increased mortality in HIV-negative patients with PCP via a mechanism independent from an increased risk of infection.
    Respiratory research 08/2013; 14(1):87. · 3.64 Impact Factor
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    ABSTRACT: The aim of this survey was to quantify refusal rates and identify factors of refusal pertaining to studies and recruiting pediatricians in the research recruitment process. We performed a cross-sectional survey on all clinical studies conducted in six pediatric Clinical Investigation Centers in France over an 18-month period. Data were retrieved using a data collection form for the characteristics of each of the studies included in the survey and a questionnaire addressed to recruiting pediatricians. Multilevel models were used for the statistical analysis. Overall, 145 pediatricians approached the families of 999 children and adolescents for participation in 44 studies. In the 36 of the 44 studies that enrolled subjects, median refusal rate was 12.5% (Q1-Q3, 0-28%). Lower refusal rates were associated with therapeutic drug use as the focus of the study [odds ratio (OR), 0.51; 95% CI: 0.25, 1.05], additional hospital stays required for the study (OR, 0.53; 95% CI: 0.28, 0.99), longer duration of the inclusion visit (OR, 0.93/10 min; 95% CI: 0.87, 1), and recruitment by a pediatrician with university teaching responsibilities (OR, 0.26; 95% CI: 0.10, 0.68). Refusal rate was higher when the recruiting pediatrician perceived the study as generating heavy practical burden for the subject and/or its family (OR, 1.3; 95% CI: 1.17, 1.45). Refusal to participate in clinical research was low and was influenced by factors associated to the objectives and conduct of the studies and factors related to the characteristics and perceptions of the recruiting pediatricians.
    Journal of clinical epidemiology 07/2013; · 5.48 Impact Factor

Publication Stats

4k Citations
883.51 Total Impact Points


  • 2010–2014
    • Unité Inserm U1077
      Caen, Lower Normandy, France
    • Université de Vincennes - Paris 8
      Saint-Denis, Île-de-France, France
  • 2013
    • Amedeo Avogadro University of Eastern Piedmont
      Novara, Piedmont, Italy
  • 2005–2013
    • French Institute of Health and Medical Research
      • Unit of Epidemiological Research on Perinatal Health and Woman's and Children's Health
      Paris, Ile-de-France, France
  • 2004–2013
    • Hôpital Universitaire Robert Debré
      • Service d’Accueil des Urgences Pédiatriques
      Lutetia Parisorum, Île-de-France, France
  • 2008–2012
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
  • 2009
    • University of Tours
      Tours, Centre, France
    • University of Tehran
      Teheran, Tehrān, Iran
  • 2005–2007
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2003–2007
    • Institut de Cancérologie Gustave Roussy
      Île-de-France, France
  • 2002
    • Hôpital Paris Saint Joseph
      Lutetia Parisorum, Île-de-France, France
  • 2000
    • Mercy Hospital St. Louis
      San Luis, Missouri, United States
  • 1999
    • Ministry of Health, France
      Lutetia Parisorum, Île-de-France, France