📇 Rhumatologue · CRETEIL · (94) · Salarié

MME MURIEL KLAHR-ELFASSI

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Auteur de référence en rhumatologie
29 articles scientifiques publiés — un praticien à la pointe de la recherche
Délais de RDV courts dans la région
134 rhumatos / 100 000 hab. — département bien doté

Rhumatologue

📍 CRETEIL (94)SalariéRPPS 10001061497

✨ Génération du profil synthétique IA en cours…

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Top publications · les plus citées

Unlocking prognostic insights in severe tricuspid regurgitation: impact of right ventricular volumes and function by cardiac magnetic resonance

European heart journal. Cardiovascular Imaging · 2025

📚 4 citations

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Abstract Aims To describe prognostic cut-off values of right ventricular (RV) size and function by cardiac magnetic resonance (CMR) in a multicentre cohort of patients with severe tricuspid regurgitation (TR). Methods and results The study enrolled patients with at least severe TR (severe, massive, and torrential) assessed by 2D echocardiography undergoing a contemporary CMR study. The primary endpoint was defined as combined endpoint of all-cause mortality or hospitalization for heart failure (HF) events, and the secondary endpoint was defined as cardiovascular mortality. Three hundred fourteen patients with severe TR were included in this study (70 ± 11 years, 67% female, 79% NYHA I or II). During a median follow-up of 35 months (interquartile range: 12–60), 39% of the patients experienced the combined endpoint. After adjusting for clinical and imaging variables, RV end-diastolic volume (RV-EDV) and RV ejection fraction (RVEF) were independently associated with all-cause mortality and HF (adj HR for RV-EDV: 1.015 [1.012–1.019], P &lt; 0.001; adj HR for RVEF: 0.957 [0.938–0.976], P &lt; 0.001). Thresholds of highest risk were defined by RV-EDV &gt; 150 mL/m² and RVEF &lt; 50%, while intermediate risk was defined by RV-EDV between 100 and 150 mL/m² and RVEF between 50% and 60%. Compared with low-risk groups, adjusted threshold for high-risk (adj HR for RV-EDV &gt; 150 mL/m2: 5.42 [3.20–9.16] and for RVEF &lt; 50%: 2.12 [1.21–3.71]) and intermediate-risk (adj HR for RV-EDV 100–150 mL/m2: 1.72 [1.11–2.64] and for RVEF 50–60%: 1.59 [1.04–2.43]) was significantly associated with impaired outcomes. Conclusion Thresholds of RV volume and function by CMR stratifying low-intermediate and high-risk of cardiovascular events are defined in a multicentre cohort of patients. Compared with low-risk group, high- and, to a lower extent, intermediate-risk groups are independently associated to HF and all-cause mortality.

Adequacy of pharmacological prescription in patients at very high risk of fracture within the FLS in Spain: analysis of the REFRA FLS-SEIOMM Registry

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025

📚 3 citations🩺 Clinique🔓 Open Access📄 PDF gratuit ↗

Hallways Feel Like Homelessness: The Geriatric Boarder Experience

Journal of the American Geriatrics Society · 2025

📚 3 citations

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ABSTRACT Background Boarding in the Emergency Department (ED) is associated with increased delirium, morbidity, and mortality. Geriatric patients are especially vulnerable to these harms and are more likely to board for a prolonged time. Although multiple studies have investigated clinical outcomes for older adults, we present the first study examining the subjective experience of geriatric boarders through qualitative methods. Methods We conducted semi‐structured interviews between June 2024 and July 2024 at a large urban academic hospital. We recruited patients over the age of 65 boarding in the ED for over four hours after an inpatient bed request. Patients were located in hallway care spaces, ED rooms, or in a dedicated unit for ED boarding patients. Interviews were transcribed, coded, and discussed for themes using grounded theory. We halted interviews when we reached thematic saturation. Results We recruited 26 participants (mean age 77). Four themes emerged: (1) Care space location matters, and border units are far preferable to hallways, (2) patients were able to compartmentalize the kindness of the hospital staff and quality of medical care from their environment, (3) boarding elicits feelings of powerlessness, and (4) older adults felt acuity of condition and dementia or frailty, rather than age, should determine who should be prioritized for an inpatient room. Conclusion Our sample of older adults felt stressed and powerless while boarding. They especially struggled in hallway care spaces and preferred dedicated units for boarding. They felt comorbidities and acuity of condition should determine prioritization for inpatient beds rather than age. These insights can help guide health systems how to improve the boarding experience for geriatric patients. More research is needed to understand the older adult's experience boarding in the ED and how to improve it.

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MME MURIEL KLAHR-ELFASSI

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Top publications · les plus citées

Publications scientifiques (29) — classées par pathologie

Transversal7

Épidémiologie & registres4

Essai clinique4

Revue / méta-analyse4

IRM ostéo-articulaire2

Pédiatrie2

Revue générale2

Arthrite juvénile1

Biomarqueurs / Auto-Ac1

Case report / série1

Économie santé1

Gériatrie1

Microbiote1

Pharmacovigilance1

Qualité de vie / PROMs1

Risque cardio-vasculaire1

Santé mentale / fatigue1

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