Alain Duhamel

Université du Droit et de la Santé Lille 2, Lille, Nord-Pas-de-Calais, France

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Publications (487)

  • Article · Oct 2016 · Anticancer research
  • Article · Oct 2016 · Anticancer research
  • Article · Oct 2016 · Anticancer research
  • Source
    Oliver Karam · Pierre Demaret · Alain Duhamel · [...] · Stéphane Leteurtre
    [Show abstract] [Hide abstract] ABSTRACT: Background Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions. Methods This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer–Lemeshow test). Results Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71–0.81) and the Hosmer–Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1. Conclusions In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.
    Full-text available · Article · Oct 2016 · Annals of Intensive Care
  • A. Deny · C. Loiez · V. Deken · [...] · H. Migaud
    [Show abstract] [Hide abstract] ABSTRACT: Hypothesis: Risk factors for a MRSA infection can be identified from a cohort of patients with S. aureus infections. Materials and methods: We identified 244 patients who experienced a S. aureus surgical site infection (SSI) in 2011-2012 documented by intraoperative sample collection. Of these 244 patients, those who had a previous SSI (n=44), those with a SSI but no orthopedic implant (n=80) or those who had the infection more than 1-year after the initial surgery (n=5) were excluded. This resulted in 115 patients (53 arthroplasty, 62 bone fixation) being analyzed for this study. There were 24 MRSA infections and 91 MSSA infections. The following factors were evaluated in bivariate and multifactorial analysis: age, sex, type of device (prosthesis/bone fixation), predisposition (diabetes, obesity, kidney failure), and environmental factors (hospitalization in intensive care unit within past 5 years, nursing home stay). Results: Two factors were correlated with the occurrence of MRSA infections. (1) Nursing home patients had a higher rate of MRSA infections (67% vs. 18%, P=0.017) with an OR of 8.42 (95% CI: 1.06-66.43). (2) Patients who had undergone bone fixation had a lower rate of MRSA infections than patients who had undergone arthroplasty (13% vs. 30%, P=0.023), OR 0.11 (95% CI: 0.02-0.56). Although the sample size was too small to be statistically significant, all of the patients with kidney failure (n=4) had a MRSA infection. Discussion: Since these MRSA infection risk factors are easy to identify, the antimicrobial prophylaxis could be adapted in these specific patient groups.
    Article · Oct 2016 · Orthopaedics & Traumatology Surgery & Research
  • C. Chater · L. Terriou · A. Duhamel · [...] · P. Zerbib
    Article · Sep 2016 · Journal de Chirurgie Viscerale
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: To date, there are no epidemiological data on microscopic colitis (MC) in France. The aim of this study was to determine the incidence of MC in the Somme department in Northern France, to evaluate clinical characteristics, and to search for risk factors for both collagenous colitis (CC) and lymphocytic colitis (LC). Design: Between January 1, 2005, and December 31, 2007, four pathology units in the Somme department recorded all new cases of MC diagnosed in patients living in the area. Colonic biopsies were reviewed by 4 pathologists together. For each incident case, demographic, clinical, endoscopic, and biological data were collected according to methodology of the EPIMAD registry. Results: One hundred and thirty cases of MC, including 87 CC and 43 LC, were recorded during the three-year study. The mean annual incidence for MC was 7.9/10⁵ inhabitants, 5.3/10⁵ inhabitants for CC, and 2.6/10⁵ inhabitants for LC. Annual standardized incidence of Crohn’s disease and ulcerative colitis in the EPIMAD registry during the same period (2005–2007) were 7.4/10⁵ and 4.9/10⁵, respectively. Median age at diagnosis was 63 years for MC, 70 for CC, and 48 for LC. The female-to-male gender ratio was 3.5 for MC, 4.1 for CC, and 2.6 for LC. Median time to diagnosis was 8 weeks. Chronic diarrhea and abdominal pain were, respectively, present in 93 and 47 % of the cases. An autoimmune disease was associated in 28 % of MC cases. At diagnosis, proton pump inhibitor treatment was more often reported in CC than in LC (46 vs 16 %; p = 0.003). Budesonide was effective on diarrhea in 77 % of patients, and thirteen percent of patients became steroid dependent. Conclusion: This population-based study shows that the incidence of MC in France is high and similar to Crohn’s disease incidence and confirms that this condition is associated with female gender, autoimmune diseases, and medications.
    Article · Sep 2016 · Digestive Diseases and Sciences
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    [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: Axial disorders are considered to appear late in the course of Parkinson's disease (PD). The associated impact on quality of life (QoL) and survival and the lack of an effective treatment mean that understanding and treating axial disorders is a key challenge. However, upper-body axial disorders (namely dysarthria, swallowing and breathing disorders) have never been prospectively assessed in early-stage PD patients. OBJECTIVES: To characterize upper-body axial symptoms and QoL in consecutive patients with early-stage PD. METHODS: We prospectively enrolled 66 consecutive patients with early-stage PD (less than 3 years of disease progression) and assessed dysarthria, dysphagia and respiratory function (relative to 36 controls) using both objective and patient-reported outcomes. RESULTS: The mean disease duration was 1.26 years and the mean UPDRS motor score was 19.4 out of 108. 74% of the patients presented slight dysarthria (primarily dysprosodia). Men appeared to be more severely affected (i.e. dysphonia). This dysfunction was strongly correlated with low swallowing speed (despite the absence of complaints about dysphagia), respiratory insufficiency and poor QoL. Videofluorography showed that oral-phase swallowing disorders affected 60% of the 31 tested patients and that pharyngeal-phase disorders affected 21%. 24% of the patients reported occasional dyspnea, which was correlated with anxiety in women but not in men. Marked diaphragmatic dysfunction was suspected in 42% of the patients (predominantly in men). CONCLUSION: Upper body axial symptoms were frequent in men with early-stage PD, whereas women presented worst non-motor impairments. New assessment methods are required because currently available tools do not reliably detect these upper-body axial disorders.
    Full-text available · Article · Sep 2016 · PLoS ONE
  • [Show abstract] [Hide abstract] ABSTRACT: Purpose: To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living. Method: Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study. Results: Dysarthria was the most common disorder and its characteristics varied from one patient to another. However, we frequently observed a hyperkinetic, dysarthric profile characterized by imprecise consonants, a rough voice, changes in intensity, and hypernasality. Dysphagia appeared to be slightly less frequent and less disabling than dysarthria. Most patients had difficulty swallowing solids, and the oral phase was particularly problematic. Dysarthria and dysphagia affected activities of daily living in general and the psychological/emotional domain in particular. Conclusions: The characteristics of dysarthria in oromandibular dystonia vary significantly from one patient to another due to differences in the set of affected muscles, so each patient should receive a personalized rehabilitation program. Dysarthria was the most prominent symptom, although spasmodic dysphonia was more frequent than expected. Further laboratory-based studies are needed to clarify the mechanisms and consequences of dysphagia in oromandibular dystonia.
    Article · Sep 2016 · Journal of Speech Language and Hearing Research
  • Jérémy Vanhelst · Laurent Béghin · Alain Duhamel · [...] · Frédéric Gottrand
    [Show abstract] [Hide abstract] ABSTRACT: The aim was to assess the relationship between school rhythm and physical activity (PA) in adolescents. The study included 2024 adolescents (12.5-17.4 years). Participants wore an accelerometer for 7 days. A short school rhythm was defined as a short time at school with short recesses and less time in teaching per day (Group 1). A long school rhythm was defined as a longer time at school with more time in teaching and recess (Group 2). Adolescents in Group 1 performed less moderate to vigorous PA (MVPA) than those in Group 2 per week (P < .0001), especially during school days (recess: 3.9 ± 4.0 vs. 9.8 ± 7.9 min · day(-1); P < .0001; teaching hours: 14.5 ± 9.8 vs. 19.1 ± 12.0 min · day(-1); P < .0001). Adolescents in Group 1 were less likely to meet the PA recommendations than were adolescents in Group 2: 30.7% vs. 34.1% (P < .0001). During school days, the percentage of adolescents who spent more than 2 h · day(-1) in sedentary activities was greater in the Group 1 (P < .001). Our results suggest that leisure-time out-of-school hours is used mainly for sedentary activities, and that school time provides a good opportunity for promoting PA.
    Article · Sep 2016 · Journal of Sports Sciences
  • [Show abstract] [Hide abstract] ABSTRACT: Atopic dermatitis (AD), is a chronic, inflammatory disease with a worldwide prevalence of 10 to 20% (1). Although topical corticosteroids (TCS) are known to be efficient and safe for the treatment of AD (2), there is a widespread fear about their use (topical corticosteroid phobia (TCSP)) in 40 to 73% of patients (3,4). TCSP represents the main cause of treatment failure. Until now, TCSP has been evaluated with a single binary question which is not adapted for this complex phenomenon. This article is protected by copyright. All rights reserved.
    Article · Sep 2016 · Journal of the European Academy of Dermatology and Venereology
  • D. Seguy · A. Behague · A. Duhamel
    Article · Sep 2016
  • [Show abstract] [Hide abstract] ABSTRACT: CD81 is a cell surface protein which belongs to the tetraspanin family. While in multiple myeloma its expression on plasma cells is associated with worse prognosis, this has not yet been explored in acute myeloid leukemia (AML). We measured membrane expression of CD81 on AML cells at diagnosis, evaluated its association with AML characteristics and its influence on patient outcome after intensive chemotherapy in a cohort of 134 patients. CD81 was detected in 92/134 (69%) patients. Patients with AML expressing CD81 had elevated leukocyte count (P=0.02) and were more likely classified as intermediate or adverse-risk by cytogenetics (P<0.001). CD81 expression had a negative impact on survival (event-free survival, overall survival and relapse-free survival) in univariate (P<0.001) and in multivariate analyses (P=0.003, 0.002 and <0.001, respectively). CD81 has a negative impact on OS in patients with NPM1 mutation (P=0.01) and in patients ELN-favorable (P=0.002). In conclusion, this cell surface marker may be a new prognostic marker for diagnostic risk classification and a potential therapeutic target for drug development in AML.
    Article · Aug 2016 · Oncotarget
  • [Show abstract] [Hide abstract] ABSTRACT: Background Time to progression (TTP) is often used as a primary endpoint in phase II clinical trials. Since the actual date of nadir and progression is never known, most calculated TTP are overestimated. This study evaluates the imprecision on the estimate of TTP under two hypothetical tumor kinetic settings and various assessment schedules. Design A two component tumor growth model was used to account for treatment effect assuming exponential decay for tumor shrinkage and linear growth for progression. Evolution of tumor burden (TB) was modelized according to two scenarios using either a cytotoxic or a cytostatic agent and several assessment schedules. TB, nadir, progression and TTP were simulated for each visit schedule. Results For cytotoxic agents, our model predicted response at 1.5w, a TB at nadir of 40.2mm (starting from 100mm) occurring at 6.7w and true progression at 11.2w with a TB of 48.2mm. For cytostatic agents, our model predicted no response, a TB at nadir of 77mm occurring at 9.2w and true progression at 19.4w with a TB of 92mm. Depending on the assessment schedule, estimated TTP was increased from 0.8-36.8w and from 0.6-28.6w as compared to the true TTP and varied from 5.2-298% and from 1.66-109.58% as compared to the true TB at progression for cytotoxic and cytostatic agents, respectively. Our model further show that for cytotoxic agents, evaluation of TB every 6 weeks is optimal to capture the true nadir, the time to nadir, the true progression and the true TTP whereas for cytostatic agents, this evaluation is optimal every 10 weeks. Conclusions Our results emphasize the importance to estimate the effects of tested drugs on tumor shrinkage prior to design any phase II clinical trials to choose optimal TB evaluation's timing.
    Article · Aug 2016 · Annals of Oncology
  • Jessica Giordano · Suonita Khung · Alain Duhamel · [...] · Martine Remy-Jardin
    [Show abstract] [Hide abstract] ABSTRACT: Purpose To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations. Materials and methods Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12). Results CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p < 0.0001): (1) in group 1, 96.6 % of segments with abnormal perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2. Conclusion Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy. Key Points • Depiction of chronic pulmonary embolism exclusively located on peripheral arteries is difficult. • The main differential diagnosis of pCTEPH is PAH. • The pattern of DECT perfusion changes can help differentiate PAH and pCETPH. • In PAH, almost all segments with abnormal perfusion showed patchy defects. • In pCTEPH, patchy and PE-type defects were the most frequent abnormalities.
    Article · Aug 2016 · European Radiology
  • E. Drumez · S. Putman · G. Sorin · [...] · A. Duhamel
    Article · Aug 2016 · Orthopaedics & Traumatology Surgery & Research
  • [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND Postprocedural aortic regurgitation occurs in 10 to 20% of patients undergoing transcatheter aortic-valve replacement (TAVR) for aortic stenosis. We hypothesized that assessment of defects in high-molecular-weight (HMW) multimers of von Willebrand factor or point-of-care assessment of hemostasis could be used to monitor aortic regurgitation during TAVR. METHODS We enrolled 183 patients undergoing TAVR. Patients with aortic regurgitation after the initial implantation, as identified by means of transesophageal echocardiography, underwent additional balloon dilation to correct aortic regurgitation. HMW multimers and the closure time with adenosine diphosphate (CT-ADP), a point-ofcare measure of hemostasis, were assessed at baseline and 5 minutes after each step of the procedure. Mortality was evaluated at 1 year. A second cohort (201 patients) was studied to validate the use of CT-ADP in order to identify patients with aortic regurgitation. RESULTS After the initial implantation, HMW multimers normalized in patients without aortic regurgitation (137 patients). Among the 46 patients with aortic regurgitation, normalization occurred in 20 patients in whom additional balloon dilation was successful but did not occur in the 26 patients with persistent aortic regurgitation. A similar sequence of changes was observed with CT-ADP. A CT-ADP value of more than 180 seconds had sensitivity, specificity, and negative predictive value of 92.3%, 92.4%, and 98.6%, respectively, for aortic regurgitation, with similar results in the validation cohort. Multivariable analyses showed that the values for HMW multimers and CT-ADP at the end of TAVR were each associated with mortality at 1 year. CONCLUSIONS The presence of HMW-multimer defects and a high value for a point-of-care hemostatic test, the CT-ADP, were each predictive of the presence of aortic regurgitation after TAVR and were associated with higher mortality 1 year after the procedure.
    Article · Jul 2016 · New England Journal of Medicine
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    Pierre Alexis Geoffroy · Alain Duhamel · Hélène Behal · [...] · Benjamin Rolland
    [Show abstract] [Hide abstract] ABSTRACT: Important discrepancies exist between physicians in deciding when to perform involuntary hospitalization measures (IHMs). The factors underlying these differences are poorly known. We conducted a two-year single-center retrospective study in France on patients who were referred to the emergency department (ED) with an IHM certificate written by a private-practice General Practitioner (GP). For each consultation, the official IHM motive was categorized into four groups: Suicide; Psychosis, Mania, or Melancholia (PMM); Agitation; and Other. The alcohol status of the patient was also noted. The factors underlying the ED psychiatrists' confirmation of the use of IHMs were determined using a logistic regression model. One hundred eighty-nine cases were found (165 patients; 44.2 ± 16 years, 41.3% women). The ED psychiatrists confirmed the use of IHMs in 123 instances (65.1% agreement rate). Multivariate analyses found that IHM disagreement was significantly associated with patient alcohol status and the reason for referral. Specifically, there was an increased risk of IHM disagreement when the patient had an alcohol-positive status (OR = 15.80; 95% CI [6.45– 38.67]; p < 0.0001) and when the motive for IHM was " agitation " compared with " suicide " (OR = 11.44; 95% CI[3.38–38.78]; p < 0.0001). These findings reflect significant disparities between GPs and ED psychiatrists regarding the decision to proceed to an IHM.
    Full-text available · Article · Jul 2016 · Scientific Reports
  • [Show abstract] [Hide abstract] ABSTRACT: Introduction: The long-term risk of first thrombosis and benefit of prophylaxis in antiphospholipid antibody (aPL) carriers without history of thrombosis or obstetrical morbidity is poorly known. This study aimed to evaluate the long-term rate and risk factors associated with a first thrombosis in those patients. Patients and methods: After a prior study ended in December 2005 and was already published, we extended the follow-up period of our cohort of aPL carriers. Results: Ninety-eight of the 103 patients of the previous study were included. The annual first thrombosis rate was 2.3% per patient-year during a median of 13 years (6-17). None of the baseline characteristics was predictive of risk of first thrombosis, but persistent aPL over time were associated with an increased risk. The stronger association was found in triple aPL-positive carriers: OR 3.38 (95% CI: 1.24-9.22). Of note, conversely to our previous findings, no benefit of aspirin prophylaxis was observed. Conclusion: The risk of first thrombosis in aPL carriers without history of thrombosis or obstetrical morbidity was significant, persisted linearly over time and was associated with persistent aPL. This risk was especially increased in triple aPL-positive carriers, in whom a close follow-up seems to be necessary. Nevertheless, the benefit of aspirin prophylaxis remained unclear.
    Article · Jul 2016 · Lupus
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    [Show abstract] [Hide abstract] ABSTRACT: Background: Socio-economic status (SES) is a strong determinant of eating behavior and the obesity risk. Objective: To determine which eating and lifestyle behaviors mediate the association between SES and obesity. Methods: We performed a case-control study of 318 obese people and 371 non-obese people in northern France. Ten eating behavior traits were assessed using the Three-Factor Eating Questionnaire Revised 21-Item and an eating attitude questionnaire (on plate size, the number of servings, reasons for stopping eating and the frequency of eating standing up, eating in front of the television set (TV) and eating at night). The SES score (in three categories) was based on occupation, education and income categories. Mediation analysis was performed using the test of joint significance and the difference of coefficients test. Results: The age- and gender-adjusted obesity risk was higher for individuals in the low-SES groups (odds ratio (OR) (95% confidence interval (CI)=1.82 (1.48-2.24), P<0.0001). Additional servings were associated with a higher obesity risk (OR=3.43, P<0.0001). Cognitive restraint (P<0.0001) and emotional eating (P<0.0001) scores were higher in obese participants than in non-obese participants but did not depend on SES. Of the 10 potential factors tested, eating off a large plate (P=0.01), eating at night (P=0.04) and uncontrolled eating (P=0.03) significantly mediated the relationship between SES and obesity. Conclusion: Our results highlighted a number of obesogenic behaviors among socially disadvantaged participants: large plate size, uncontrolled eating and eating at night were significant mediators of the relationship between SES and the obesity risk.International Journal of Obesity advance online publication, 5 July 2016; doi:10.1038/ijo.2016.109.
    Full-text available · Article · Jul 2016 · International journal of obesity (2005)

Publication Stats

8k Citations


  • 2001-2014
    • Université du Droit et de la Santé Lille 2
      • Faculty of Medicine
      Lille, Nord-Pas-de-Calais, France
  • 2011
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 2010
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 2004
    • Centre Hospitalier Régional Universitaire de Lille
      Lille, Nord-Pas-de-Calais, France
  • 2002
    • Lille Catholic University
      Lille, Nord-Pas-de-Calais, France