C Oliver

Aix-Marseille Université, Marsiglia, Provence-Alpes-Côte d'Azur, France

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Publications (222)558.24 Total impact

  • F. Retornaz · M. Grino · L. Mari · L. Chiche · C. Oliver

    No preview · Article · Dec 2015

  • No preview · Article · Dec 2015
  • F. Retornaz · F. Castinetti · C. Molines · C. Oliver
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    ABSTRACT: Le vieillissement est associé à une augmentation de la prévalence des pathologies thyroïdiennes. Les dysthyroïdies avérées ont très souvent une présentation clinique atypique, peu ou monosymptomatique. Les dysthyroïdies infracliniques, surtout l’hypothyroïdie, sont encore plus fréquentes. Il n’y a actuellement pas de consensus sur leur prise en charge. L’abstention thérapeutique sous réserve d’une stricte surveillance clinique et biologique est le plus souvent conseillée dans l’hypothyroïdie infraclinique. Les risques cardiaques potentiels de l’hyperthyroïdie infraclinique justifient plutôt le choix en faveur d’un traitement radical. La prévalence des nodules thyroïdiens bénins ou malins augmente avec l’âge. Le pronostic des cancers est moins bon chez la personne âgée, avec une proportion des formes histologiques d’évolution plus grave. Quelle que soit la pathologie thyroïdienne, les stratégies thérapeutiques doivent tenir compte de l’âge et de l’état général des patients. Elles sont souvent différentes de celles des personnes plus jeunes. Des résultats discordants sont rapportés sur les relations entre le statut thyroïdien et les altérations neuromusculaires et cognitives liées au vieillissement.
    No preview · Article · Nov 2013
  • F Retornaz · F Castinetti · C Molines · C Oliver
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    ABSTRACT: Aging is associated with changes in thyroid function at several levels of regulation. Thyroid hormones levels are usually within the lower part of normal values reported in the general population. Two changes in aging are of clinical importance: a shift in the distribution of TSH levels, the 97.5th percentile of the TSH distribution being within 6μUI/ml after 70 years and within 7.5μUI/ml in subjects older than 80 instead of 4.5μU/ml in the general population, and an increased prevalence of thyroid nodularity, requiring reliable and non-invasive methods of investigation in older people. Lastly, aging may be associated with comorbidities, high risk of drug interactions and under nutrition, which may make difficult the interpretation of laboratory data and in some cases induce iatrogenic thyroid diseases. Considering the high prevalence of the thyroid diseases in older patients and a better understanding of the physiopathological hormonal variations with the ageing, it seemed useful to propose a review to help the clinician in the care of these situations.
    No preview · Article · Jan 2013 · La Revue de Médecine Interne
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    ABSTRACT: Objectives: To evaluate the ability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. Equipment and methods: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis. Results: 297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p<0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p=0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p<0.001). Conclusion: The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.
    No preview · Article · Sep 2012 · European journal of radiology
  • S Boullu · JG Velut · C Oliver · M Grino

    No preview · Article · Aug 2012
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    ABSTRACT: Today there is a better understanding of the events involved in the initiation and progression of thyroid cancer. It is indeed now known that BRAF and RAS mutations and RET/PTC and PAX8/PPARγ rearrangements account for the majority of molecular alterations detected in differentiated thyroid cancers. Abnormal regulation of microRNAs (miRNAs) is also a promising way of research. The diagnostic utility and prognostic value of detecting these molecular events has been analyzed in several recent studies. BRAF mutation analysis improves the performance of fine-needle aspiration diagnosis by increasing specificity in "indeterminate" cytologies and sensitivity in false negatives. Testing for a "panel of mutations" (BRAF, RAS, RET/PTC and PAX8/PPARγ) improves the performance, detecting papillary carcinomas with non-classic histology. The specificity of these analyzes is excellent but their sensitivity is still insufficient. In the future, specific miRNAs expression profiles in thyroid carcinoma and identification of new mutations might provide interesting information. Several studies have found that BRAF mutations are associated with a more aggressive tumor behavior, a higher risk of recurrence and treatment failure. With regard to the other mutations and rearrangements, current data are conflicting and it seems premature to draw practical conclusions applicable in routine practice. Lastly, targeted therapy with tyrosine kinase inhibitors, based on our understanding of the molecular mechanisms of thyroid oncogenesis, has shown promise in metastatic, progressive, and radioactive iodine-refractory differentiated thyroid carcinomas.
    No preview · Article · Apr 2012 · Annales d Endocrinologie
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    ABSTRACT: Our objective was to report a single-center experience of the management of pituitary tumor apoplexy. We retrospectively analyzed a series of 44 patients hospitalized for pituitary apoplexy between January 1996 and March 2008 at the Timone Hospital, Marseille, France. Most frequent presenting symptoms were headaches (93%), visual impairment (85%) and vomiting (59%). Hypopituitarism was present at diagnosis in 88% of patients, with a high incidence of corticotroph deficiency (70%). A risk factor was found in 52% of patients, mostly hypertension. Apoplexy occurred in a previously undiagnosed pituitary adenoma in 32/44 cases (73%). The apoplectic event concerned 12 secreting, 27 non-functioning, 4 uncharacterized adenomas and one Rathke's pouch cyst. Nineteen patients underwent surgery within the first month, and one patient had conventional radiotherapy. Twenty-four patients, who had no ophthalmic or neurological signs, were conservatively treated in first intention; among them, 6 received high dose corticosteroids. After a median follow-up of 21 months, there was no significant difference in terms of endocrine or visual recovery between the operated and the conservatively treated groups, nor between patients treated with corticosteroids or not. Panhypopituitarism was observed in 52% of patients, but partial or complete visual recovery was present in the majority of patients (91%), whatever the therapeutic approach. The outcome of patients treated with or without surgery for pituitary apoplexy without severe neuro-ophthalmic deficits seems to be identical, pleading for a conservative management of pituitary apoplexy in the absence of visual emergency.
    No preview · Article · Jul 2011 · Journal of endocrinological investigation
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    ABSTRACT: The determination of elasticity index by elastography has been recently proposed in the evaluation of thyroid nodules, since malignancy is correlated with stiffness of the nodules. The aim of this report is to give an overview on different techniques and results reported by eleven groups active on the field. Advantages and limitations of elastography are also discussed. In our opinion, further studies, preferentially multicentric, are necessary before being able to conclude about the place of elastography in thyroid nodules evaluation, versus fine-needle aspiration cytology (FNAC), the gold standard. Indeed, elastography could reduce FNAC or at least allow to select nodule's (or nodular zone's) for aspirations.
    No preview · Article · Apr 2011 · Annales d Endocrinologie
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    ABSTRACT: Elastography uses ultrasound (US) to assess elasticity. Shear wave elastography (SWE) is a new technique that estimates tissue stiffness in real time and is quantitative and user independent. The aim of the study was to assess the efficiency of SWE in predicting malignancy and to compare SWE with US. Ninety-three patients and 39 control subjects were included in the study. Predictive value of SWE was assessed by correlation between elasticity, US parameters, and histology. Elasticity index (EI) was first analyzed alone. Scores have been constructed with echographic parameters, i.e. vascularity, hypoechogenicity, and microcalcifications (Score 1=US Score), and with the same parameters plus EI (Score 2=US+SWE Score). For statistical analysis, univariate and multivariate analysis and receiver operating characteristic curves were used. A total of 146 nodules from 93 patients were analyzed. Twenty-nine nodules (19.9%) were malignant. Mean (±sd) EI was 150±95 kPa (range, 30-356) in malignant nodules vs. 36±30 (range, 0-200) kPa in benign nodules (P<0.001, Student's t test). For a positive predictive value of at least 80%, characteristics of tissue elasticity (cutoff, 65 kPa) were: sensitivity=85.2%, and specificity=93.9%. Characteristics of the US Score were: sensitivity=51.9% [95% confidence interval (CI), 33.1; 70.7], and specificity=97% (95% CI, 93.6; 1). Characteristics of the US+SWE Score were: sensitivity=81.5% (95% CI, 66.9; 96.1), and specificity=97.0% (95% CI, 93.6; 1). Promising results have been obtained with SWE. This technique may be applied to multinodular goiters. Larger prospective studies are needed to confirm these results and to define the respective places of SWE, US, and FNA.
    Preview · Article · Sep 2010 · The Journal of Clinical Endocrinology and Metabolism
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    ABSTRACT: Introduction L’élastographie utilise les ultrasons pour évaluer l’élasticité des tissus. L’EOC est une nouvelle technique qui permet d’estimer la dureté des tissus de manière focale. Elle a l’avantage d’être quantitative, en temps réel et indépendante de l’opérateur. Le but de cette étude est d’évaluer l’efficacité de l’EOC pour prédire la malignité et de la comparer avec les caractéristiques échographiques usuelles. Patients et Méthodes 93 patients et 39 sujets témoins ont été inclus. La valeur prédictive de l’EOC a été établie par des corrélations entre l’élasticité, les paramètres échographiques et l’histologie. L’index d’élasticité (IE) a été analysé dans un premier temps seul. Puis des scores ont été construits avec les paramètres échographiques : vascularisation intranodulaire, hypo-échogénicité et microcalcifications (score1 = score Echo), et avec les mêmes paramètres échographiques plus l’IE (score2 = score Echo+ IE). Pour l’analyse statistique, des études uni et multivariées ont été menées et des courbes ROC ont été réalisées. Résultats 146 nodules ont été analysés chez 93 patients. Vingt neuf nodules étaient malins (19,9 %). L’IE moyen était de 150 KPa ± 95 (30-356) pour les nodules malins vs 36 KPa ± 30 (0-200) pour les bénins (p < 0,001, test T de Student). Pour une valeur prédictive positive > 80 % : les caractéristiques de l’index d’élasticité (IE) (cut off: 65 kPa) étaient : sensibilité = 85,2 %, spécificité = 93,9 %. Les caractéristiques du score Echo étaient : sensibilité = 51,9 % [33,1 ; 70,7] % et spécificité = 97 % [93,6 ; 1] %, et pour le score Echo+ IE : sensibilité = 81,5 % [66,9 ; 96,1] % et spécificité = 97,0 % [93,6 ; 1] %. Conclusions L’élastographie par ondes de cisaillement (EOC) donnent des résultats encourageants. Une étude prospective plus importante devrait être entreprise pour confirmer ces résultats et définir la place respective de l’EOC, de l’échographie classique et de la cytoponction.
    No preview · Article · Sep 2010 · Journal de Chirurgie Viscerale
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    ABSTRACT: Adrenal insufficiency is caused by primary adrenal failure or by impairment of the corticotropic axis. In both situations, cortisol secretion is deficient, and hydrocortisone is a logical replacement therapy. However, no consensus guideline for dosing has been published, and clinicians adapt the dose empirically after only a clinical evaluation. Under this regimen, some patients receiving an inappropriately high dose of cortisol feel comfortable and also have an increased risk of adverse effects. We performed a pharmacokinetic study of cortisol in patients with adrenal insufficiency to evaluate plasma concentrations when the dosing was based on clinical examination and to develop a model allowing optimization of drug dosing. This was a prospective, open-label study in two endocrinology departments and a clinical investigation centre (Assistance Publique Hôpitaux de Marseille, Marseille, France). Fifty patients with primary (n = 20) or secondary (n = 30) adrenal insufficiency were recruited. All patients were given their usual hydrocortisone replacement regimen. Blood samples for cortisol measurements were drawn at 0600, 0800, 1000, 1200, 1400, 1600, 1800, 2000, 2200 and 0000 h. The observed values were compared with the known physiological range throughout the day (0800, 1600 and 0000 h). A population pharmacokinetic analysis was performed using nonlinear mixed-effects modelling software (NONMEM). The final pharmacokinetic model was then used to simulate several hydrocortisone dosing scenarios. Thirteen different treatment regimens for 50 patients were observed. The cortisol plasma concentrations were compared with the physiological range and showed that 79%, 55% and 45% of patients were over- or under-treated at 0800, 1600 and 2400 h, respectively. The cortisol concentrations showed wide variability and were best described using a one-compartment model with zero-order input and first-order elimination. The pharmacokinetic parameters (intersubject variability) were the following: duration of absorption 0.54 hour, volume of distribution 38.7 L (39.7%) and clearance 12.1 L/h (23.2%). The proportional residual error was 32.3%. This final model was then used to simulate 18 different dosing regimens. The regimen with the highest proportion of simulated patients within the physiological targets was 10 + 5 + 5 mg at 0730, 1200 and 1630 h, respectively. However, even with this regimen, about 54%, 44% and 32% of patients would remain over- or under-treated at 0800, 1600 and 2400 h, respectively. Most patients with adrenal insufficiency are imperfectly treated with hydrocortisone relative to their plasma cortisol concentrations. Using simulation, a standard dosing regimen is suggested, which increases the proportion of patients within the physiological target concentrations. However, an individualized dose adjustment would be more accurate.
    No preview · Article · Jul 2010 · Clinical Pharmacokinetics
  • F. Castinetti · F. Ouliac · N. Lesavre · C. Oliver

    No preview · Article · Sep 2008 · Feuillets de biologie
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    ABSTRACT: Aim. - Sporadic malignant insulinoma (SMI) is a rare disease, and the consequent paucity of data in the literature and the development of aggressive treatments for liver metastases have led us to retrospectively analyze a series of 12 cases of SMI. Methods. - Every patients presenting with SMI, according to the WHO 2004 histopathology criteria, between 1970 and June 2005 in Marseille was included in the study. Patients with multiple endocrine neoplasia type 1 (MEN-1) and tumours of uncertian malignant potential were excluded. Results. - The ratio of male/female was 4/8 and mean age at diagnosis was 52.5 years. A 48-h fasting test in 10 patients was conclusive in nine, after a mean duration 12j 45 min. SMI size ranged from 7-120 mm (mean 30.3mm). Six patients had liver metastases and one had isolated lymph-node invasion. Surgery was performed in 12 patients. Five persisting diseases (mean follow-up of 1.8 years) required other treatments (chemoembolization, radiofrequency thermoablation [RFTA], liver transplantation); one patients relapsed 8.5 years after surgery; six were still in complete remission (mean follow-up of 5.8 years), and one patient had died by the time of the 24-month follow-up. Conclusion. - Aggressive sequential multimodal therapy can prolong the survival of patients with SMI even in the presence of liver metastases. (c) 2008 Published by Elsevier Masson SAS.
    No preview · Article · Sep 2008 · Diabetes & Metabolism
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    ABSTRACT: Data on effects of statins on resting oxidant-antioxidant status are contradictory and no study has been published on the effects of statins on exercise-induced oxidative stress. We carried out a 6-month longitudinal study in 10 dyslipidemic patients receiving 10 mg/day atorvastatin and 13 healthy sedentary subjects. Thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA) were measured in plasma at rest and every 5 minutes after submaximal isometric thumb adduction and handgrip sustained until exhaustion. At inclusion, resting TBARS and RAA levels in controls and patients did not differ and exercise increased TBARS and decreased RAA. Atorvastatin reduced resting TBARS and RAA levels in a time-dependent but lipid-independent manner. The main effect was a post-exercise increase in TBARS, without affecting the post-exercise RAA levels. The reduction in oxidative stress occurred earlier in oxidative muscles involved in thumb adduction. In conclusion, atorvastatin lowers resting oxidant-antioxidant activity: exercise-induced oxidative stress occurs mainly in muscles having a high oxidative capacity.
    No preview · Article · May 2007 · International journal of clinical pharmacology and therapeutics

  • No preview · Article · Dec 2006 · Annals of the New York Academy of Sciences

  • No preview · Article · Dec 2006 · Annals of the New York Academy of Sciences

  • No preview · Article · Oct 2006 · Annales d Endocrinologie
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    ABSTRACT: To study alterations in muscle function combining physiological, electrophysiological and metabolic measurements in patients receiving a statin at various dosages during long-term therapy. A 3-month (D0, D30 and D90) longitudinal physiological and electrophysiological muscle study was performed in 26 patients receiving 10, 40 or 80 mg/day atorvastatin. All subjects performed maximal (MVC) and submaximal (60% MVC) isometric thumb adduction, handgrip and knee extension exercises during the recording of surface electromyograms (EMG) of the adductor pollicis (AP), flexor digitorum (FD) and vastus lateralis (VL). The compound muscle potential (M-wave) evoked by direct muscle stimulation was measured at rest and after 60% MVCs and the EMG power spectrum was analyzed during sustained effort. Blood was sampled from an antecubital vein for measurements of pH, lactate and potassium levels after thumb adduction and handgrip exercises. The measurements were repeated on Day 0 (D0), D30 and D90. Atorvastatin did not affect the MVC and endurance time to fatigue. Post-exercise M-wave alterations in the AP began at D30 with the 80 mg/day treatment and there was a reduced or suppressed leftward shift in the EMG power spectrum in the AP and VL with all 3 dosages. In the AP, the EMG changes appeared earlier (D30) with 80 mg/day whereas they only occurred at D90 on the lower dosages. Atorvastatin had no effect on the maximal postexercise variations in pHv and lactate but it significantly reduced the maximal increase in plasma potassium concentration after thumb adduction and handgrip exercise, the effects being only present at D90 on 10 mg/day but occurring as early as D30 with higher dosages. A 3-month atorvastatin treatment did not affect the maximal performance of skeletal muscle during voluntary efforts but EMG analysis revealed a reduced muscle excitability and an attenuated adaptation to fatigue. These effects prevailed in muscles containing the largest proportion of slow-oxidative fibers and were associated with a reduced outward flow of potassium.
    No preview · Article · Jul 2006 · International journal of clinical pharmacology and therapeutics
  • S Boullu-Ciocca · P Verger · A Bocquier · C Oliver
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    ABSTRACT: Several indicators of corticotropic axis hyperactivity have been observed in common abdominal obesity, which is clinically similar to the obesity found in Cushing's syndrome. Corticotropic axis hyperactivity may be involved in the development and metabolic and cardiovascular complications of abdominal obesity. Several mechanisms may be responsible for this hormonal dysregulation: genetic, lifestyle, and nutritional factors, and chronic stress. We note the necessity of methodologically-impeccable clinical studies for an objective evaluation of the role of stress in obesity.
    No preview · Article · Jan 2006 · La Presse Médicale

Publication Stats

3k Citations
558.24 Total Impact Points

Institutions

  • 1989-2012
    • Aix-Marseille Université
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2010
    • Creatis Medical Imaging Research Center
      Lyons, Rhône-Alpes, France
  • 2008
    • Hôpital Européen, Marseille
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2005-2006
    • Assistance Publique Hôpitaux de Marseille
      • Service d'endocrinologie, nutrition et maladies métaboliques
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 1998
    • Institut Paoli Calmettes
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 1996
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France
  • 1991-1995
    • Slovak Academy of Sciences
      • Institute of Experimental Endocrinology
      Bratislava, Bratislavsky Kraj, Slovakia
  • 1994
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 1981-1994
    • Polytech Marseille
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 1992
    • University of Naples Federico II
      • Department of Molecular Medicine and Medical Biotechnology
      Napoli, Campania, Italy
  • 1987
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 1986
    • Institut Pasteur
      Lutetia Parisorum, Île-de-France, France