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1.
Int J Cosmet Sci ; 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39049718

RESUMEN

OBJECTIVE: This study focused on the development of a new-to-world ingredient harnessing the natural potential of fresh Jasminum grandiflorum flowers to self-ferment by its phytobiome revealing flower content. Analytical investigations were conducted to highlight specific phytocompounds generated during the natural fermentation of flowers in comparison to a conventional extraction. The synergy with another extraction technology maximized the generation of biocompounds for an interesting efficacy. METHODS: Jasmine extract was elaborated by combining two patented technologies: the phytofermentology™, inspired by plant-microorganisms interaction and designed to develop ingredients obtained by natural fermentation of the vegetal using its own phytobiota; and the PSR™ technology allowing the extraction of bioactive phytocompounds such as small RNAs from plants. RESULTS: Analytical investigations of Jasmine extract highlighted uniqueness and richness of the phytocompound profiles, such as organics acids and phenolic compounds, markers of fermentation only obtained after phytofermentology in comparison to conventional extraction. Jasmine extract has the particularity to contain jasmintides, flower small peptides belonging to the family of cysteine-rich peptides (CRPs). Antioxidant and global anti-ageing properties were investigated in cell-free assays demonstrating interesting results: about 20% scavenging of free radicals from 0.5% of Jasmine extract and protection from DNA damage of 26% in comparison to a stressed control. CONCLUSION: Phytofermentology™ technology combined with PSR™ technology, meant to be respectful of the environment, allowed to development of biofunctionals very close to nature with a unique analytical signature as Jasmine extract, using the potential of fresh flowers phytobiota to self-ferment. The efficacy of the ingredient on global antioxidation and anti-ageing via hyaluronidase/tyrosinase inhibitions was highlighted by cell-free evaluation assays. Further and complementary studies should be conducted to confirm the bioefficacy of this ingredient with in vitro / ex vivo assays.


Cette étude a pour objectif de développer un nouvel ingrédient unique en exploitant le potentiel des fleurs fraîches de Jasminum grandiflorum à fermenter naturellement en utilisant leur phytobiome, révélant ainsi le contenu de ces fleurs. Des investigations analytiques ont été menées pour mettre en évidence des phytocomposés spécifiques générés lors de la fermentation naturelle des fleurs par rapport à une extraction conventionnelle. La synergie avec une autre technologie d'extraction maximise la génération de biocomposés pour une plus grande efficacité de l'extrait. L'extrait de jasmin a été élaboré en combinant deux technologies brevetées: la phytofermentologie™, inspirée de l'interaction plante/micro­organismes et conçue pour développer des ingrédients obtenus par fermentation naturelle d'un végétal en utilisant son propre phytobiote; et la technologie PSR™ permettant l'extraction de phytocomposés bioactifs tels que les petits ARN des plantes. Les recherches analytiques de l'extrait de jasmin ont mis en évidence le caractère unique et la richesse des profils des différents phytocomposés composant l'extrait, tels que les acides organiques et les composés phénoliques, marqueurs de fermentation obtenus uniquement grâce à la phytofermentologie par rapport à l'extraction conventionnelle. L'extrait de jasmin a la particularité de contenir des jasmintides, petits peptides de fleurs appartenant à la famille des peptides riches en cystéine (CRP). Les propriétés antioxydantes et anti­âge ont été étudiées par des tests acellulaires démontrant des résultats intéressants: environ 20 % d'élimination des radicaux libres à partir de 0,5 % d'extrait de jasmin et une protection contre les dommages à l'ADN de 26 % par rapport à un contrôle stressé. La technologie phytofermentologie™ combinée à la technologie PSR™, se voulant respectueuse de l'environnement, a permis de développer des ingrédients très proches de la nature avec une signature analytique unique comme l'extrait de Jasmin, utilisant le potentiel d'auto­fermentation du phytobiote des fleurs fraîches. L'efficacité de l'ingrédient sur l'antioxydation globale et l'anti­âge via les inhibitions enzymatiques de la hyaluronidase et de la tyrosinase a été mise en évidence par des tests d'évaluation acellulaires. Des études supplémentaires et complémentaires devraient être menées pour confirmer la bioefficacité de cet ingrédient avec des tests in vitro/ex vivo.

2.
Ann Dermatol Venereol ; 150(3): 189-194, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37225615

RESUMEN

BACKGROUND: The factors associated with early relapse of infantile haemangioma (IH) after a first course of treatment with oral propranolol for at least six months (initiated after the marketing authorization had been granted) have not previously been investigated. OBJECTIVES: To identify factors associated with the risk of early relapse in children with IH treated with oral propranolol according to the current prescribing guidelines. METHODS: We performed a multicentre, retrospective, case-control study, using the Ouest Data Hub database. All children treated for at least 6 months with oral propranolol for IH between 31 June 2014 and 31 December 2021, and with a follow-up visit at least three months after treatment discontinuation were included. A case was defined as relapse of IH within three months of treatment discontinuation; each case was matched for age at treatment initiation and for centre, with four (relapse-free) controls. The association between relapse and treatment or IH characteristics was expressed as an odds ratio (OR) from univariate and multivariate conditional logistic regressions. RESULTS: A total of 225 children were included. Of these, 36 (16%) relapsed early. In a multivariate analysis, a deep IH component was a risk factor for early relapse [OR = 8.93; 95%CI: 1.0-78.9, p = 0.05]. A propranolol dosage level of less than 3 mg/kg/day protected against early relapse [OR = 0.11; 95%CI: 0.02-0.7, p = 0.02]. Tapering before propranolol discontinuation was not associated with a lower risk of early relapse. CONCLUSION: The risk factors for late and early relapse are probably different. Investigation of the risk factors for early vs. late IH relapse is now warranted.


Asunto(s)
Hemangioma Capilar , Neoplasias Cutáneas , Niño , Humanos , Lactante , Estudios de Casos y Controles , Estudios Retrospectivos , Propranolol/uso terapéutico , Enfermedad Crónica , Resultado del Tratamiento , Administración Oral , Neoplasias Cutáneas/tratamiento farmacológico
3.
Br J Dermatol ; 185(4): 764-771, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-33735442

RESUMEN

BACKGROUND: Oral alitretinoin is a retinoid used for severe chronic hand eczema. Although caution is recommended for patients with uncontrolled dyslipidaemia or cardiovascular risk factors, the actual atherothrombotic risk has not been investigated thus far. OBJECTIVES: To detect any excess of atherothrombotic events among patients exposed to alitretinoin, during treatment or in the 2 years following initiation. METHODS: Using the French Health Insurance database, we compared the number of patients who had an atherothrombotic event (coronary artery disease, ischaemic stroke or peripheral artery disease requiring revascularization) in the population exposed to oral alitretinoin vs. the general population of the same age, sex and baseline cardiovascular risk, using standardized morbidity ratios (SMRs). RESULTS: Between 2009 and 2017, 19 513 patients were exposed to oral alitretinoin in France. Sixty-four (0·3%) patients had an atherothrombotic event while on alitretinoin. Patients receiving alitretinoin experienced no more atherothrombotic events than the general population: patients without cardiovascular risk factors or previous atherothrombotic events had a SMR of 0·65 [95% confidence interval (CI) 0·26-1·34] during alitretinoin treatment, and 1·21 (95% CI 0·90-1·59) in the 2 years following initiation; patients with cardiovascular risk factors or previous atherothrombotic events had a SMR of 0·82 (95% CI 0·60-1·08) during alitretinoin treatment and 0·95 (95% CI 0·82-1·09) in the 2 years following initiation. Taken separately, SMRs for each outcome did not increase either. CONCLUSIONS: These data from an exhaustive nationwide population-based study do not support an increase in the incidence of atherothrombotic events with alitretinoin use, regardless of the baseline cardiovascular risk of the patient.


Asunto(s)
Isquemia Encefálica , Fármacos Dermatológicos , Accidente Cerebrovascular , Alitretinoína , Estudios de Cohortes , Humanos , Tretinoina/efectos adversos
4.
J Eur Acad Dermatol Venereol ; 34(6): 1293-1301, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31587374

RESUMEN

BACKGROUND: Although the causal role of isotretinoin in suicidal behaviour is controversial, suicide attempts (SA) do occur among patients taking isotretinoin. OBJECTIVES: To describe patient profiles and the management of isotretinoin among patients who committed or attempted suicide under treatment. To assess the risk factors for SA under isotretinoin. METHODS: We performed a comprehensive case series of suicides and SAs under isotretinoin, and a case-control study, using Nationwide French Health Insurance database. The main analysis compared cases (subjects with a SA during a course of isotretinoin) to controls, individually matched for age, gender and rank of the current course; controls were to be exposed to isotretinoin at the index date (date of SA for the corresponding cases). The patients' psychiatric history at isotretinoin initiation was studied. In a secondary analysis, patients who continued their isotretinoin treatment after their SA were compared to patients who discontinued it. RESULTS: In all, 328 018 subjects started a course of isotretinoin between 1 January 2010 and 31 December 2014 and 184 patients were hospitalized for a SA; half of them had a psychiatric history at initiation. In the multivariate analysis, psychiatric history and history of anxiety alone were risk factors for SA [Odds ratio (OR), 18.21; 95% confidence interval (CI), 9.96-33.30 and 4.78; 95% CI, 2.44-9.33, respectively]. Among 176 cases of SA with sufficient follow-up, 103 (58.5%) carried on with their treatment after their SA. Treatment initiation by a dermatologist was inversely associated with the continuation of the treatment after a SA (OR, 0.38; 95% CI, 0.18-0.80). CONCLUSIONS: Suicide attempts under isotretinoin are rare events, and our results suggest that most of the patients concerned have a risk-prone profile detectable at the time of treatment initiation. The risk-benefit ratio of continuing isotretinoin after a SA warrants further careful evaluation.


Asunto(s)
Ansiedad/psicología , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Trastornos Mentales/psicología , Intento de Suicidio/estadística & datos numéricos , Acné Vulgar/tratamiento farmacológico , Reclamos Administrativos en el Cuidado de la Salud , Adolescente , Adulto , Estudios de Casos y Controles , Bases de Datos Factuales , Femenino , Francia , Humanos , Masculino , Aceptación de la Atención de Salud/estadística & datos numéricos , Factores de Riesgo , Adulto Joven
5.
Prog Urol ; 26(16): 1163-1170, 2016 Dec.
Artículo en Francés | MEDLINE | ID: mdl-28279366

RESUMEN

INTRODUCTION: The aim of this study was to assess the impact of the acquisition of a Da Vinci® robot on the use and outcomes of partial nephrectomy (PN). PATIENTS AND METHODS: It was a single center retrospective study including 280 patients who underwent PN from January 2006 to May 2013. The number of PN, tumors and patients' characteristics and perioperative outcomes have been assessed over 3 periods defined according to the main surgical approach: 2006-2008 (open PN), 2008-2010 (laparoscopic PN) and 2010-2013 (robotic PN). RESULTS: Over the study period, the surgical approach has changed significantly in favor of minimally-invasive surgery and especially robotic approach. The PN/nephrectomy rate has also evolved to a higher proportion of PN over radical nephrectomy (P=0.002). No significant difference was noted between the three periods in terms of tumor size but there was a higher rate of highly complex tumors (RENAL score≥10) during the last period (10.7%; 18.6% and 33.2%; P=0.04). Warm ischemia time increased from 2006-2008 to 2008-2010 (26 vs. 23minutes) but decreased thereafter during the robotic era (14.5minutes; P<0.001). Regarding postoperative outcomes, the only change was a decreased length of stay over time (P=0.003). CONCLUSION: In this single center series, the robotic approach was associated with a spread of PN and with an improvement of nephron-sparing surgery outcomes. LEVEL OF EVIDENCE: 4.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Humanos , Neoplasias Renales , Laparoscopía , Nefrectomía , Nefronas , Estudios Retrospectivos , Resultado del Tratamiento
7.
J Eur Acad Dermatol Venereol ; 29(8): 1530-8, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25623140

RESUMEN

BACKGROUND: Mutations of BRAF, NRAS and c-KIT oncogenes are preferentially described in certain histological subtypes of melanoma and linked to specific histopathological features. BRAF-, MEK- and KIT-inhibitors led to improvement in overall survival of patients harbouring mutated metastatic melanoma. OBJECTIVES: To assess the prevalence and types of BRAF, NRAS, c-KIT and MITF mutations in cutaneous and mucous melanoma and to correlate mutation status with clinicopathological features and outcome. METHODS: Clinicopathological features and mutation status of 108 samples and of 98 consecutive patients were, respectively, assessed in one retrospective and one prospective study. Clinicopathological features were correlated with mutation status and the predictive value of these mutations was studied. RESULTS: This work identified significant correlations between BRAF mutations and melanoma occurring on non-chronic sun-damaged skin and superficial spreading melanoma (P < 0.05) on one hand, and between NRAS mutations and nodular melanoma (P < 0.05) on the other hand. Younger age (P < 0.05), microscopic (P < 0.05) and macroscopic (P < 0.05) lymphatic involvement at diagnosis of primary melanoma were significantly linked to BRAF mutations. A mutated status was a positive predictive factor of a response to BRAF inhibitors (OR = 3.44). Mutated melanoma showed a significantly (P = 0.038) higher objective response rate to cytotoxic chemotherapy (26.3%) than wild-type tumours (6.7%). CONCLUSION: Clinical and pathological characteristics of the primary melanoma differed between wild-type and BRAF- or NRAS-mutated tumours. Patients with BRAF-mutated tumours were younger at diagnosis of primary melanoma. Patients carrying mutations showed better responses better to specific kinase inhibitors and interestingly also to systemic cytotoxic chemotherapy.


Asunto(s)
GTP Fosfohidrolasas/genética , Melanoma/genética , Proteínas de la Membrana/genética , Factor de Transcripción Asociado a Microftalmía/genética , Mutación , Proteínas Proto-Oncogénicas B-raf/genética , Proteínas Proto-Oncogénicas c-kit/genética , Neoplasias Cutáneas/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Membrana Mucosa , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Adulto Joven
8.
Prog Urol ; 25(1): 27-33, 2015 Jan.
Artículo en Francés | MEDLINE | ID: mdl-25450751

RESUMEN

OBJECTIVE: To assess the influence of vascular clamping and ischemia time on long-term post-operative renal function following partial nephrectomy (PN) for cancer in a solitary kidney. PATIENTS AND METHODS: This is a retrospective study including 259 patients managed by PN between 1979 and 2010 in 13 centers. Clamping use, technique choice (pedicular or parenchymal clamping), ischemia time, and peri-operative data were collected. Pre-operative and last follow-up glomerular filtration rates were compared. A multivariate analysis using a Cox model was performed to assess the impact of ischemia on post-operative chronic renal failure risk. RESULTS: Mean tumor size was 4.0±2.3cm and mean pre-operative glomerular filtration rate was 60.8±18.9mL/min. One hundred and six patients were managed with warm ischemia (40.9%) and 53 patients with cold ischemia (20.5%). Thirty patients (11.6%) have had a chronic kidney disease. In multivariate analysis, neither vascular clamping (P=0.44) nor warm ischemia time (P=0.1) were associated with a pejorative evolution of renal function. Pre-operative glomerular filtration rate (P<0.0001) and blood loss volume (P=0.02) were significant independent predictive factors of long-term renal failure. CONCLUSION: Renal function following PN in a solitary kidney seems to depend on non-reversible factors such as pre-operative glomerular filtration rate. Our findings minimize the role of vascular clamping and ischemia time, which were not significantly associated with chronic renal failure risk in our study. LEVEL OF EVIDENCE: 5.


Asunto(s)
Fallo Renal Crónico/etiología , Neoplasias Renales/cirugía , Nefrectomía/métodos , Anciano , Pérdida de Sangre Quirúrgica , Isquemia Fría , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Factores de Tiempo , Isquemia Tibia
9.
Neuroepidemiology ; 42(3): 186-95, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24662236

RESUMEN

BACKGROUND: Population-based stroke registries are necessary to evaluate the precise burden of stroke. The methodology used in the Brest Stroke Registry and an estimation of its completeness are described. METHODS: 'Hot pursuit' as well as 'cold pursuit' were used, and five sources of identification were included: emergency wards, brain imaging, practitioners, death certificates and hospital-based electronic research. Ascertainment for each case was certified by a neurologist. Inclusion criteria were: (1) age >15 years; (2) a stroke defined by WHO criteria or all neurological deficits lasting at least 1 h. Completeness was estimated using capture-recapture method. RESULTS: For 2008, 2009 and 2010, 851, 898, 823 patients were collected, respectively. The number of sources of identification per patient was as follows: one source: 30.8, 24.1 and 18.7%; two sources: 54.5, 42.9 and 31.0%; three sources: 13.4, 30.1 and 46%; four sources: 1.3, 3.0 and 3.8%. Capture-recapture analysis showed data completeness over 90%. Standardized cumulative first-ever stroke incidence using a world standard population was 87 in 2008, 87 in 2009 and 84 in 2010. CONCLUSIONS: Case ascertainment by a neurologist, numerous sources, as well as 'hot' and 'cold' pursuit can provide a reliably large data set suitable for further epidemiological studies.


Asunto(s)
Sistema de Registros , Accidente Cerebrovascular/epidemiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Accidente Cerebrovascular/mortalidad
11.
NPJ Prim Care Respir Med ; 33(1): 33, 2023 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-37777534

RESUMEN

In France, most spirometries are performed by pneumologists. Spirometry is difficult to access due to the distance to medical office and long delays for appointments. This lack of accessibility contributes to the underdiagnosis of chronic obstructive pulmonary disease (COPD) among patients aged between 40 and 75 years. In recent years, general practitioners (GPs) have been performing spirometry in private practice. However, the extent of this practice is unknown. A French retrospective, repetitive transversal study analysed data from the "Système National des Données de Santé" (SNDS) database. The targeted population was GPs in primary care that performed spirometries between 2010 and 2018, in patients aged between 40 and 75 years. Between 2010 and 2018, 302,674 (7.2%) spirometries were performed in France by GPs in private practices, in patients 40 to 75 years old. 5.4% by "expert GPs" (>60 spirometries/year) and 1.8% by "non-expert GPs". In "non-expert GPs" (2.8% of French GPs in 2018), the annual number of spirometries increased by 701 each year (p < 2.104), the annual number of GPs performing spirometries increased by 114 each year (p < 2.10-5). Overall, 24.9% of the spirometries performed by GPs were referrals from other GPs. The number of spirometries performed by GPs and the number of GPs performing spirometries has gradually increased over time. However, this increase is inadequate considering the need to early detect and follow up respiratory disorders.


Asunto(s)
Medicina General , Médicos Generales , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Espirometría , Francia
12.
Climacteric ; 15(3): 235-40, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22612609

RESUMEN

Prior to 1996, the use of postmenopausal estrogen was not believed to increase the risk of venous thrombosis. Subsequent studies, particularly the prospective, randomized, double-blind, clinical trial of the Women's Health Initiative, have clearly shown an increase in the incidence and risk of venous thrombosis in postmenopausal women using conjugated equine estrogens with or without medroxyprogesterone acetate. The risk of venous thrombosis in postmenopausal women is also increased by obesity and age. Oral hormone therapy has been used principally for management of menopausal symptoms. Transdermal estrogens have not been used as extensively in the United States but have a significant use in Europe. Recent observational studies have indicated no increased risk of venous thrombosis with use of transdermal estrogens. Norpregnane derivatives have been associated with an increased risk of venous thrombosis, suggesting that progestins may contribute to the increased risk in postmenopausal women using estrogen plus progestin therapy.


Asunto(s)
Terapia de Reemplazo de Estrógeno/efectos adversos , Estrógenos/efectos adversos , Posmenopausia , Progestinas/efectos adversos , Trombosis de la Vena/epidemiología , Salud de la Mujer , Administración Cutánea , Factores de Edad , Anciano , Terapia de Reemplazo de Estrógeno/tendencias , Estrógenos/administración & dosificación , Estrógenos Conjugados (USP)/efectos adversos , Femenino , Humanos , Acetato de Medroxiprogesterona/efectos adversos , Persona de Mediana Edad , Obesidad/complicaciones , Progestinas/administración & dosificación , Factores de Riesgo , Trombosis de la Vena/etiología
14.
J Thromb Haemost ; 5(10): 2020-4, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17883698

RESUMEN

BACKGROUND: The vitamin K epoxide reductase complex subunit 1 (VKORC1) recycles endogenous vitamin K, a cofactor for vitamin K-dependent coagulation factor synthesis. Common polymorphisms in VKORC1, the gene coding for VKORC1, have been found to affect the dose response to vitamin K antagonists, and to confer an increased risk of vascular diseases in a Chinese population. The aim of this study was to evaluate the association between the VKORC1 1173C > T polymorphism and venous thromboembolism (VTE). METHODS: We report the results of a case-control study designed to evaluate interactions between acquired and inherited risk factors of VTE. We studied 439 cases hospitalized with a first venous thromboembolic event that was not related to a major acquired risk factor for VTE, and 439 matched controls. The VKORC1 1173C > T polymorphism was selected for genotyping as the tagging single-nucleotide polymorphism for previously identified VKORC1 haplotypes. RESULTS: The relationship between VTE and the VKORCI 1173C > T polymorphism was consistent with a recessive model. The frequency of the VKORCI TT genotype was lower in cases than in controls. The odds ratio (OR) (95% CI) was 0.62 (0.41-0.94) for the TT genotype as compared to CT/CC genotypes. Adjustment on cardiovascular diseases, body mass index, factor V (FV) and prothrombin gene mutations did not alter the results. CONCLUSIONS: In this case-control study, the frequency of the VKORCI TT genotype was lower in patients with VTE than in matched controls. The clinical consequence of these results remains to be determined, but gives new perspectives for exploration of the role of VKORCI polymorphism in the pathogenesis of VTE.


Asunto(s)
Oxigenasas de Función Mixta/genética , Polimorfismo Genético , Trombosis de la Vena/genética , Anciano , Estudios de Casos y Controles , Factor V/genética , Femenino , Frecuencia de los Genes , Humanos , Masculino , Persona de Mediana Edad , Mutación , Oportunidad Relativa , Polimorfismo de Nucleótido Simple , Protrombina/genética , Factores de Riesgo , Vitamina K Epóxido Reductasas
15.
Fundam Clin Pharmacol ; 21(6): 643-50, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18034665

RESUMEN

Cohort studies suggest that exposure to antipsychotic agents may be associated with an increased risk of venous thromboembolism (VTE). Few data concerning antidepressant drugs are available. Using a different methodological approach, the aim of this study was to estimate the association between neuroleptic and antidepressant drug use and the risk of VTE. We report the results of a case-control study designed to evaluate interactions between acquired and inherited risk factors of VTE. We included 677 cases hospitalized with deep vein thrombosis and or pulmonary embolism with no major acquired risk factor for VTE, and 677 controls matched for gender and age. Drug exposure was defined as current use of drugs at admission. Neuroleptic exposure was associated with an increased risk of VTE (OR = 2.1, 95% CI 1.4-3.2). Among neuroleptics, antipsychotic agent use was associated with a 3.5-fold increased risk of VTE (OR = 3.5, 95% CI 2.0-6.2). No association was found between antidepressant drug exposure and the risk of VTE (OR = 1.1, 95% CI 0.9-1.5). In this hospital-based case-control study, exposure to antipsychotic drugs was associated with an increased risk of VTE. These results, added to previous results, suggest that clinicians should consider antipsychotic drug exposure as a potential risk factor of VTE. More studies are needed in order to further elucidate this adverse effect, and to determine the possible predisposing factors and the biological mechanisms involved.


Asunto(s)
Antidepresivos/efectos adversos , Antipsicóticos/efectos adversos , Tromboembolia Venosa/inducido químicamente , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
16.
Arch Pediatr ; 14(5): 454-60, 2007 May.
Artículo en Francés | MEDLINE | ID: mdl-17317120

RESUMEN

OBJECTIVES: To identify the incidence and risk factors of breastfeeding difficulties in maternity using 3 indicators: excess neonatal weight loss in maternity (EWL>or=10%), delayed onset of lactation (DOL>or=72 h) and suboptimal infant breastfeeding behaviour (SIBB=IBFAT score60 ml (OR=2.36). CONCLUSION: Difficulties in the breastfeeding initiation are not uncommon. Influencing factors are not always modifiable. Breastfeeding couples considered at risk should be recognized and should benefit from a special lactation guidance in maternity and from a post-discharge follow-up.


Asunto(s)
Lactancia Materna , Adulto , Peso Corporal , Femenino , Humanos , Conducta del Lactante , Recién Nacido , Trastornos de la Lactancia , Masculino , Proyectos Piloto , Estudios Prospectivos , Factores de Riesgo
18.
J Thromb Haemost ; 4(1): 71-6, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16409454

RESUMEN

BACKGROUND: Lifetime estrogen exposure has been related to breast cancer risk, osteoporosis, and cardiovascular disease but data on venous thromboembolism (VTE) risk are limited. METHODS: Data from a hospital-based case-control study among 608 postmenopausal women (191 with a first episode of idiopathic VTE and 417 age-matched controls) were used to determine whether estrogen exposure, as assessed by age at menopause [classified as early (< or = 45 years), normal (46-54 years) and late menopause (> or = 55 years)] and parity, was associated with the risk of VTE. RESULTS: After adjustment for potential confounding variables, the risk of VTE was increased with each year's delay in the menopause [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10, P < 0.0075]. When compared with women with normal menopause used as a reference, the adjusted OR for VTE was 0.59 (95% CI = 0.36-0.97) and 2.53 (95% CI = 1.28-4.99) for women with early menopause and late menopause, respectively (P = 0.001). Adjusted OR for VTE was also higher for women with more than two children when compared with those with less than or equal to two children (1.56, 95% CI = 1.03-2.34, P = 0.03). The lowest risk of VTE was observed in women with early menopause and lower parity (adjusted OR = 0.60, 95% CI = 0.30-1.24), the highest risk was among women with late menopause who have had more than two children (adjusted OR = 3.41, 95% CI = 1.46-9.25). CONCLUSION: These results show that the longer exposure to endogenous estrogen is associated with an increased VTE risk.


Asunto(s)
Estrógenos/sangre , Menopausia , Trombosis de la Vena/etiología , Factores de Edad , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Oportunidad Relativa , Paridad , Embarazo , Embolia Pulmonar/epidemiología , Embolia Pulmonar/etiología , Riesgo , Tromboembolia/epidemiología , Tromboembolia/etiología , Trombosis de la Vena/epidemiología
19.
J Thromb Haemost ; 4(4): 793-9, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16634748

RESUMEN

BACKGROUND: Moderate hyperhomocysteinemia and B vitamins deficiency are thought to be risk factors for venous thromboembolism (VTE). The causality and independence of those associations are still questioned. METHODS: We measured fasting serum total homocysteine, folates, and vitamin B12 levels as well as 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T genotypes in 467 patients hospitalized with a first well-documented deep vein thrombosis and/or pulmonary embolism not related to a major acquired risk factor and 467 controls matched for gender and age. RESULTS: Mild hyperhomocysteinemia, low serum folates, and vitamin B12 were associated with VTE independently of each other. In multivariate analysis, odds ratios (OR) (95% CI) for VTE associated with mild hyperhomocysteinemia (>15 micromol L(-1)), low serum folates (< or = 4.9 nmol L(-1)), and vitamin B12 (< or = 253 pmol L(-1)) were 1.48 (1.05-2.08), 3.14 (1.35-7.32) and 1.42 (1.03-1.98), respectively. An MTHFRC677T genotype was not significantly associated with VTE; OR (95% CI): 1.13 (0.70-1.81) CONCLUSIONS: The current data provides further knowledge in the complex relationship between hyperhomocysteinemia, low vitamin levels, and VTE.


Asunto(s)
Hiperhomocisteinemia/complicaciones , Trombosis de la Vena/sangre , Trombosis de la Vena/diagnóstico , Vitamina B 12/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Persona de Mediana Edad , Estudios Prospectivos , Embolia Pulmonar/complicaciones , Factores de Riesgo , Trombosis de la Vena/complicaciones
20.
J Thromb Haemost ; 4(6): 1259-65, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16706969

RESUMEN

BACKGROUND: Oral estrogen use and elevated body mass index (BMI) increase the risk of venous thromboembolism (VTE). Recent data suggest that transdermal estrogen might be safe with respect to thrombotic risk. However, the impact of transdermal estrogen on the association between overweight (25 kg m(-2) < BMI < or = 30 kg m(-2)) or obesity (BMI >30 kg m(-2)) and VTE risk has not been investigated. METHODS: We carried a multicenter case-control study of VTE among postmenopausal women aged 45-70 years, between 1999 and 2005, in France. Case population consisted of women with a first documented idiopathic VTE. We recruited 191 hospital cases matched with 416 hospital controls and 62 outpatient cases matched with 181 community controls. RESULTS: The odds ratio (OR) for VTE was 2.5 [95% confidence interval (CI):1.7-3.7] for overweight and 3.9 (95% CI: 2.2-6.9) for obesity. Oral, not transdermal, estrogen was associated with an increased VTE risk (OR = 4.5; 95% CI: 2.6-7.7 and OR = 1.1; 95% CI: 0.7-1.7, respectively). Compared with non-users with normal weight, the combination of oral estrogen use and overweight or obesity further enhanced VTE risk (OR = 10.2; 95% CI: 3.5-30.2 and OR = 20.6; 95% CI: 4.8-88.1, respectively). However, transdermal users with increased BMI had similar risk as non-users with increased BMI (OR = 2.9; 95% CI: 1.5-5.8 and OR = 2.7; 95% CI: 1.7-4.5 respectively for overweight; OR = 5.4; 95% CI: 2.1-14.1 and OR = 4.0; 95% CI: 2.1-7.8 respectively for obesity). CONCLUSIONS: In contrast to oral estrogen, transdermal estrogen does not confer an additional risk of idiopathic VTE in women with increased BMI. The safety of transdermal estrogen on thrombotic risk has to be confirmed.


Asunto(s)
Terapia de Reemplazo de Estrógeno/efectos adversos , Estrógenos/administración & dosificación , Estrógenos/efectos adversos , Obesidad/complicaciones , Tromboembolia/etiología , Trombosis de la Vena/etiología , Administración Cutánea , Administración Oral , Anciano , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia , Factores de Riesgo
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