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Auteur de référence en rhumatologie
37 articles scientifiques publiés — un praticien à la pointe de la recherche
Cabinet de groupe — continuité de soins
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110.1 rhumatos / 100 000 hab. — département bien doté
✨ Génération du profil synthétique IA en cours…
SELARL HYGIE
5 RUE ALFRED ENGEL, 68100 MULHOUSE
CABINET DU DR BARBARA DELEMAZURE
1 RUE SAINT SAUVEUR, 68100 MULHOUSE
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Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).
Alimentary pharmacology & therapeutics · 2026
ABSTRACT Background and Aims Acute or chronic exposure to drugs or herbal and dietary supplements (HDS) can cause drug‐induced autoimmune‐like hepatitis (DI‐ALH), a self‐limiting condition resembling autoimmune hepatitis (AIH). We investigated the prevalence of drug exposure among AIH patients at diagnosis to recognise cases of DI‐ALH and discern features predicting AIH development. Methods We retrospectively included 705 patients diagnosed with AIH. DI‐ALH was defined using published criteria. The clinical, biochemical, serological, and histological data of DI‐ALH and AIH were analysed to identify predictors of the evolution of each phenotype. Results Most patients were female ( n = 496, 70%), with a median age of 57 years and a median follow‐up of 55 months. A 59% ( n = 417) reported exposure to drugs or HDS, and 8% ( n = 58) fulfilled the criteria for DI‐ALH. Statins and HDS were the most common culprits. Patients with DI‐ALH more frequently had acute severe or fulminant hepatitis (22% vs. 12%, p = 0.013) and higher transaminase levels (ALT: 966 vs. 591, p = 0.001) at diagnosis. In total, 97% of the patients received immunosuppression. DI‐ALH patients had a faster biochemical response than i‐AIH patients (4 vs. 5, p = 0.031), while treatment withdrawal was attempted in only 29% ( n = 17). Approximately 30% ( n = 17) of DI‐ALH cases presented a flare during follow‐up. Neither clinical, histological, nor serological findings nor RUCAM and RECAM could predict a DI‐ALH flare. Conclusions DI‐ALH is often under‐recognised in clinical practice, leading to unnecessary long‐term immunosuppression. A causal relationship between drugs and AIH, along with an attempt to withdraw treatment and long‐term follow‐up, is essential to prevent overtreatment‐associated risks.
Gut · 2025
Introduction Colonic diverticulosis is the most common structural abnormality of the colon in developed countries, with an increasing global prevalence. Approximately 20–25% of affected individuals develop symptoms, collectively referred to as diverticular disease. Given its wide clinical spectrum, evolving pathophysiological insights and growing disease burden, updated guidance is essential. Methods This International Consensus, developed by 32 experts from 14 countries through a structured Delphi process based on the PICO framework and GRADE methodology, provides evidence-based recommendations across five domains: epidemiology and pathogenesis; clinical features; diagnosis; medical therapy; and surgical management. Results Key statements define diverticulosis as the presence of diverticula without symptoms and diverticular disease as diverticula associated with symptoms or complications. High dietary fibre intake is protective whereas smoking, obesity and the use of non-steroidal anti-inflammatory drugs, corticosteroids, opioids or immunotherapy increase risk. Imaging is essential in suspected acute diverticulitis: ultrasound may be appropriate in experienced hands, while CT remains preferred for complicated cases. Diverticulosis itself requires no treatment. In symptomatic uncomplicated diverticular disease, dietary fibre, selected probiotics, mesalazine and rifaximin may help relieve symptoms. Routine antibiotic use is not recommended for acute uncomplicated diverticulitis, and elective surgery should be individualised, prioritising quality of life considerations over episode count. Conclusions These Consensus statements aim to standardise and optimise the diagnosis, management and prevention of diverticular disease across diverse healthcare systems, while highlighting research priorities such as microbiome characterisation, genetic risk profiling and long-term outcomes of selective antimicrobial and surgical strategies.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026
PURPOSE Circulating tumor DNA (ctDNA) is emerging as a promising tool to monitor treatment response in large B-cell lymphoma (LBCL). Tracking tumor-specific phased variants (PVs) allows ultrasensitive detection of minimal residual disease (MRD) that may enhance the accuracy of response assessment. Previous studies have been constrained by small cohort size, retrospective design, or assays limited to a single commercial provider. PATIENTS AND METHODS DIRECT was a prospective, multisite study evaluating the utility of ctDNA in patients with LBCL. We developed a lymphoma-customized, open-source, ctDNA assay and pipeline that captured hundreds of PVs per patient. Using landmark analysis, we evaluated the prognostic impact of PV-supported MRD at the end of first-line therapy (EoT). RESULTS EoT PV-MRD status was available for 155 patients. After a median of 24.5 months, 2-year time to tumor progression (TTP) for patients with detectable versus undetectable PV-MRD was 42% versus 95%, respectively ( P < .001; hazard ratio [HR], 13.7). When restricted to patients receiving full-dose anthracycline-based immunochemotherapy, 2-year TTP was 45% versus 96%, respectively ( P < .001; HR, 15.4), outperforming conventional radiological response assessment (HRs, 6.9 for positron emission tomography v 16.9 for PV-MRD). The limit of detection with 95% confidence (LoD95) varied by more than two orders of magnitude across patients, underscoring the need to report patient-specific LoD95. Persistent PV-MRD in the absence of relapse was noted, including three of four patients with transformed follicular lymphoma, highlighting a potential caveat when interpreting positive PV-MRD . CONCLUSION EoT PV-MRD enables sensitive and clinically meaningful response assessment in LBCL. It provides independent prognostic information, enhancing EoT response assessment beyond conventional radiologic assessment. Our findings support the incorporation of PV-MRD into clinical trials and routine management of diffuse LBCL.
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
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Elena F, Sofia N, Paola P, Laura P, et al.
American journal of ophthalmology · 2026 · Journal Article
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The American journal of gastroenterology · 2026 · Journal Article
Colecchia L, Marasco G, Capelli C, Facciorusso A, et al.
International ophthalmology · 2026 · Journal Article
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DeBattista JL, Zahra G, Barbara C, Schembri J, et al.
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