📇 Rhumatologue · TESSY BOCAGE · (50) · Libéral
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Source : HAL — archive ouverte CCSD/CNRS (couvre articles, chapitres EMC, communications congrès, thèses).
EHPAD LES QUATRE SAISONS
47 R DE LA FONTAINE SAINT PIERRE, 50420 TESSY BOCAGE
CABINET DU DR ETIENNE LEMOINE
CABINET MEDICAL PASTEUR, 50420 TESSY SUR VIRE
EHPAD L'ELVODY
R DU CLOS FLEURI SAINT-GERMAIN-DE-TALLEVENDE, 14500 VIRE NORMANDIE
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Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).
Source : Google News (recherche par nom complet — homonymes possibles, vérifier le contenu).
📰 Ouest-France · 30/11/2018
<a href="https://news.google.com/rss/articles/CBMiowFBVV95cUxQcFpocHI1YnFDOC1jZThFVmpXSVBZY2NDcEM3NU1QS2U2MmgtNk82QWdDMzd6SWMwVmJhOWxFeVhOQkhyZGZ5ZXVIWjZtdWh5M1Q5OGZ2WUR2SjBadUZjdjMwZnpCVmNFSk40VkFpcWQyc1pqZDNrV1Z2NmtyQWZhUzVkWWlzQTE5NmFubGx2Tkx3bFllRVF4cHRTUGFVU0kwMDRz?oc=5" target="_blank">La Mais
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
ABSTRACT Background Immunosuppression in kidney transplant recipients with decreased graft function and histological vascular changes can be particularly challenging. The impact of a late rescue conversion to belatacept on kidney graft survival in this context has never been studied. Methods We report a bicentric retrospective cohort study comparing a calcineurin inhibitor (CNI) to belatacept switch versus CNI continuation in 139 kidney transplant recipients with histological kidney vascular damage (cv ≥2, g + cpt ≤1, i + t ≤1) and low estimated glomerular filtration rate (≤40 mL/min/1.73 m²). Primary outcome was death-censored graft survival. Results During the study follow-up, 10 graft losses (14.5%) occurred in the belatacept group (n = 69) versus 26 (37.1%) in the matched CNI group (n = 70) (P = .005). Death-censored graft survival was significantly higher in the belatacept group (P = .001). At 3 years, graft survival was 84.0% in the belatacept group compared with 65.1% in the control group. Continuing CNI was an independent risk factor for graft loss [hazard ratio (HR) 3.46; P &lt; .005]. The incidence of cellular rejection after the conversion was low (4.3% in both groups) and not significantly different between groups (P = .84). Patients switched to belatacept developed significantly less donor-specific antibodies de novo. Belatacept was an independent risk factor for the occurrence of opportunistic infections (HR 4.84; P &lt; .005). Conclusion The replacement of CNI with belatacept in patients with decreased allograft function and vascular lesions is associated with an improvement in graft survival and represents a valuable option in a context of organ shortage. Caution should be exercised regarding the increased risk of opportunistic infection.
Transplant infectious disease : an official journal of the Transplantation Society · 2021
AbstractIntroductionMicrosporidiosis is an emerging opportunistic infection in renal transplantation (RT) recipients. We aimed to describe its clinical presentation and treatment.Materials and methodsWe collected microsporidiosis cases identified in RT recipients between 2005 and 2019 in six French centers from the Crystal, Divat and Astre prospective databases.ResultsWe report 68 RT recipients with intestinal microsporidiosis; the patients were predominantly male (61.8%), with a median age of 58 (46–69) years. Infection occurred at a median time of 3 (0.8–6.8) years posttransplant. Only Enterocytozoon bieneusi was found. Microsporidiosis manifested as diarrhea (98.5% of patients) with weight loss (72.1%) and acute renal injury (57.4%) without inflammatory biological parameters. The therapeutic approaches were no treatment (N = 9), reduction of the immunosuppressive regimen (∆IS) (N = 22), fumagillin alone (N = 9), fumagillin and ∆IS (N = 19), and albendazole or nitazoxanide and ∆IS (N = 9). Overall clinical remission was observed in 60 patients (88.2%). We observed no acute kidney rejection, renal transplant failure, or death within 6 months after microsporidiosis.ConclusionE. bieneusi is an underestimated opportunistic pathogen in RT recipients, and infection with E. bieneusi leads to diarrhea with important dehydration and acute renal injury. The treatment is based on the reduction of the immunosuppressive regimen and the administration of fumagillin if available.
Frontiers in psychology · 2022
BackgroundSurgery is a cornerstone of breast cancer management. Prior to surgery, a wire marker is placed at the site of the tumor, to enable the surgeon to accurately localize the lesion during later surgery. This procedure can generate considerable anxiety for many patients. We investigated the value of conversational hypnosis (CH) in reducing anxiety in patients undergoing preoperative wire placement under radiographic control.MethodsRandomized, multicentre study in 7 centers in France. Inclusion criteria were patients aged &gt;18 years with an Eastern Cooperative Oncology Group performance status ≤2, scheduled to undergo preoperative wire placement in one or several breast lesions. Patients were randomized in a 1:1 ratio, stratified by center to undergo preoperative wire placement with or without the use of CH by a radiological technician trained in the CH technique. The primary endpoint was the percentage of patients with an anxiety score ≥ 6 on a visual analog scale ranging from 0 (absence of anxiety) to 10 (maximal anxiety). Secondary endpoints were pain score, perceived duration reported by the patient, technician satisfaction with their relationship with the patient, and ease of marker insertion reported by the radiologist. Semi-structured interviews were performed with patients to assess their perception of the marker placement procedure.ResultsThe trial was prematurely interrupted for futility after a planned interim analysis after accrual of 167 patients, i.e., half the planned sample size. Prior to marker placement, 29.3% (n = 24) of patients in the control group had an anxiety score ≥ 6, versus 42.3% (n = 33) in the CH group (p = 0.08). After marker placement, the change of anxiety score was not significantly different between groups (11.0% (n = 9) versus 14.3% (n = 11), p = 0.615). There was no significant difference in any of the secondary endpoints. In the interviews, patients from both groups frequently spoke of a feeling of trust.ConclusionThis study failed to show a benefit of conversational hypnosis on anxiety in patients undergoing marker placement prior to surgery for breast cancer. The fact that some caregivers had learned this personalized therapeutic communication technique may have had a positive impact on the whole caregiving team.Trial registrationThe study was registered with ClinicalTrials.gov (NCT02867644).
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023 · Journal Article
Bertrand D, Matignon M, Morel A, Ludivine L, et al.
Transplant infectious disease : an official journal of the Transplantation Society · 2021 · Journal Article
Dumond C, Aulagnon F, Etienne I, Heng AE, et al.
Brachytherapy · 2025 · Journal Article
Lemoine L, Adam V, Salleron J, Cuisinier C, et al.
Frontiers in psychology · 2022 · Journal Article
Lemoine L, Adam V, Galus X, Siles P, et al.
Brachytherapy · 2025 · Journal Article
Lemoine L, Adam V, Salleron J, Cuisinier C, et al.
Frontiers in psychology · 2022 · Journal Article
Lemoine L, Adam V, Galus X, Siles P, et al.