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1.
Addict Biol ; 29(2): e13373, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38380791

RESUMEN

Online poker gambling (OPG) involves various executive control processes and emotion regulation. In this context, we hypothesized that online poker players, accustomed to handling virtual cards, would show high performance on computerized decision-making tasks such as the Iowa Gambling Task (IGT). Using press advertisements, we recruited a non-gambler group (NG; n = 20) and an OPG group (n = 22). All participants performed the IGT while their cerebral activity was recorded by electroencephalography. Compared with the OPG group, the NG group showed significantly better progression in the IGT in the last trials. Recording of brain activity revealed the appearance of a temporal map between 150 and 175 ms specific to the gain condition in both groups. A second map was observed at 215-295 ms specifically in the NG group, and the generators were identified in the occipital regions. This activity is indicative of a high level of visual awareness; thus, it reflects additional processing of visual information, which can be assumed to be induced by the lower exposure of the NGs to online card games. We hypothesize that the absence of this activity in the OPG group might be due to their online habituation to virtual environments.


Asunto(s)
Juego de Azar , Humanos , Juego de Azar/psicología , Función Ejecutiva , Lóbulo Occipital , Toma de Decisiones
2.
Clin Chem Lab Med ; 61(7): 1150-1157, 2023 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-36919280

RESUMEN

In May 2022, the European Regulation 2017/746 (IVDR) came into force. It changes the approach of in vitro medical devices (IVD-MDs) for industry and institutions. It reinforces the clinical evidence requirements to improve performance, safety and transparency. Despite extended transition periods and existing guides, IVDR remains difficult to interpret and bringing devices into compliance requires efforts. The generation of clinical evidence is essential to demonstrate compliance with IVDR, and encompasses scientific validity, analytical performance and clinical performance. It is required to demonstrate, per intended use in the target population and clinical care pathway, IVD-MDs clinical performance (compared to a predefined clinical performance). Thus, there is a need for IVD-manufacturers and end-users in health care institutions, to obtain guidance on how to generate this clinical evidence. This article aims industrials and clinicians to identify key steps imposed by the IVDR for bringing IVD-MDs to the EU-market. We propose a general view of performance evaluation requirements for IVD-MDs and provide key references, including how to establish study design that will enable to document clinical performance of existing, refined or emerging medical tests. Finally, we propose a roadmap to address the relevant questions and studies in relation to the documents requested in the IVDR.


Asunto(s)
Equipos y Suministros , Regulación Gubernamental , Equipos y Suministros/normas , Unión Europea
3.
Birth ; 50(3): 513-524, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-35960611

RESUMEN

BACKGROUND: The objective of this study was to assess the preliminary efficacy and safety of conservative management compared with systematic suture in isolated vaginal or first-degree perineal tears after birth. METHODS: We conducted a preliminary efficacy, open-label, randomized, controlled, and prospective trial. This study implemented Simon's 2-step plan (interim analysis and final analysis) to test the success rate of the digital compression strategy group. Primiparous women aged ≥18 years with isolated vaginal or first-degree perineal tears after spontaneous vaginal birth of a cephalic presenting term (≥37 weeks) neonate were randomly allocated to the conservative management (CM) group (digital compression if bleeding followed by suture if persistent bleeding) or a systematic suture (SS) group. The primary outcome was the success of the intervention 10 days after delivery, defined by pain as evaluated using a visual analog scale < 3, satisfactory healing defined by a REEDA score ≤ 2, and no bleeding or infection. Sexual well-being was assessed at 2 and 6 months postpartum. RESULTS: Among 861/2209 eligible women, 143 consenting women with a superficial perineal tear were randomized: 72 in the systematic suture group and 71 in the conservative management group. Success rate was 87.8% (90% CI [70.5-93.54]) (42/55) in the systematic suture group vs 90% (90% CI [78.3-93.8]) (53/61) in the conservative management group. The REEDA score was significantly higher in the systematic suture group (1.4 vs 0.9; P = 0.036). Perineal pain was significantly higher at day 1 in the systematic suture group (2.38 vs 1.69; P = 0.034). For the Female Sexual Functional Index score, no significant difference was found between the two groups at inclusion or at 2 and 6 months postpartum. CONCLUSIONS: Conservative management of superficial perineal tears shows an efficacy rate ≥90%. Women in the conservative management group had less pain at the 1st day follow-up and lower REEDA scores at the 10th day follow-up.


Asunto(s)
Laceraciones , Complicaciones del Trabajo de Parto , Embarazo , Recién Nacido , Femenino , Humanos , Adolescente , Adulto , Estudios Prospectivos , Tratamiento Conservador , Perineo/lesiones , Complicaciones del Trabajo de Parto/cirugía , Suturas , Dolor , Laceraciones/terapia , Episiotomía/efectos adversos , Parto Obstétrico/efectos adversos
4.
Eur Radiol ; 32(8): 5559-5567, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35267093

RESUMEN

OBJECTIVES: To quantify and model normal foetal lung and liver elasticities between 24 and 39 weeks of gestation (WG) using two-dimensional shear wave elastography (2D-SWE). To assess the impact of the distance between the probe and the target organ on the estimation of elasticity values. METHODS: Measurements of normal foetal lungs and liver elasticity were prospectively repeated monthly between 24 and 39 WG in 72 foetuses using 2D-SWE. Elasticity was quantified in the proximal lung and in the region inside the hepatic portal sinus. The distance between the probe and the target organ was recorded. Trajectories representing foetal lung and liver maturation from at least 3 measurements over time were modelled. RESULTS: The average elasticity for the lung and liver was significantly different from 24 WG to 36 WG (p < 0.01). Liver elasticity increased during gestation (3.86 kPa at 24 WG versus 4.45 kPa at 39 WG). From 24 WG to 32 WG, lung elasticity gradually increased (4.12kPa at 24 WG, 4.91kPa at 28 WG, 5.03kPa at 32 WG, p < 0.002). After 32 WG, lung elasticity decreased to 4.54kPa at 36 WG and 3.94kPa at 39 WG. The dispersion of the average elasticity values was greater for the lung than for the liver (p < 0.0001). Variation in the elasticity values was less important for the liver than for the lung. The values were considered valid and repeatable except for a probe-lung distance above 8cm. CONCLUSION: Foetal lung and liver elasticities evolve differently through gestation. This could reflect the tissue maturation of both organs during gestation. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT03834805 KEY POINTS: • Prenatal quantification of foetal lung elasticity using 2D shear wave elastography could be a new prenatal parameter for exploring foetal lung maturity. • Liver elasticity increased progressively from 24 weeks of gestation (WG) to 39 WG, while lung elasticity increased first between 24 and 32 WG and then decreased after 32 WG. • The values of elasticity are considered valid and repeatable except for a probe-lung distance above 8cm.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Elasticidad , Diagnóstico por Imagen de Elasticidad/métodos , Femenino , Humanos , Hígado/diagnóstico por imagen , Cirrosis Hepática , Pulmón/diagnóstico por imagen , Embarazo
5.
Oncologist ; 25(5): e843-e851, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32212354

RESUMEN

BACKGROUND: Malnutrition worsens health-related quality of life (HRQoL) and the prognosis of patients with advanced cancer. This study aimed to assess the clinical benefits of parenteral nutrition (PN) over oral feeding (OF) for patients with advanced cancer cachexia and without intestinal impairment. MATERIAL AND METHODS: In this prospective multicentric randomized controlled study, patients with advanced cancer and malnutrition were randomly assigned to optimized nutritional care with or without supplemental PN. Zelen's method was used for randomization to facilitate inclusions. Nutritional and performance status and HRQoL using the European Organization for Research and Treatment of Cancer QLQ-C15-PAL questionnaire were evaluated at baseline and monthly until death. Primary endpoint was HRQoL deterioration-free survival (DFS) defined as a definitive deterioration of ≥10 points compared with baseline, or death. RESULTS: Among the 148 randomized patients, 48 patients were in the experimental arm with PN, 63 patients were in the control arm with OF only, and 37 patients were not included because of early withdrawal or refused consent. In an intent to treat analysis, there was no difference in HRQoL DFS between the PN arm or OF arm for the three targeted dimensions: global health (hazard ratio [HR], 1.31; 95% confidence interval [CI], 0.88-1.94; p = .18), physical functioning (HR, 1.58; 95% CI, 1.06-2.35; p = .024), and fatigue (HR, 1.19; 95% CI, 0.80-1.77; p = .40); there was a negative trend for overall survival among patients in the PN arm. In as treated analysis, serious adverse events (mainly infectious) were more frequent in the PN arm than in the OF arm (p = .01). CONCLUSION: PN improved neither HRQoL nor survival and induced more serious adverse events than OF among patients with advanced cancer and malnutrition. Clinical trial identification number. NCT02151214 IMPLICATIONS FOR PRACTICE: This clinical trial showed that parenteral nutrition improved neither quality of life nor survival and generated more serious adverse events than oral feeding only among patients with advanced cancer cachexia and no intestinal impairment. Parenteral nutrition should not be prescribed for patients with advanced cancer, cachexia, and no intestinal failure when life expectancy is shorter than 3 months. Further studies are needed to assess the useful period with a potential benefit of artificial nutrition for patients with advanced cancer.


Asunto(s)
Neoplasias , Calidad de Vida , Caquexia/etiología , Caquexia/terapia , Humanos , Neoplasias/complicaciones , Nutrición Parenteral , Estudios Prospectivos
6.
Eur Radiol ; 30(3): 1593-1600, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31776742

RESUMEN

OBJECTIVES: To compare sequential fluoroscopy guidance with spiral guidance in terms of safety, effectiveness, speed and radiation in interventional whole body procedures. METHODS: This study was a retrospective analysis of data from the prospective, randomised controlled, multicentre CTNAV2 study. The present analysis included 385 patients: 247 in the sequential group (SEQ) and 138 in the spiral group (SPI). Safety was assessed by the number of major complications. Effectiveness was measured according to the number of targets reached. Data on procedural time and radiation delivered to patients were also collected. RESULTS: There was no significant difference between the two groups (SEQ vs SPI) regarding the success rate (99.6% vs 99.3%, p = 0.680), procedural time (7 min 40 s ± 5 min 48 s vs 7 min 13 s ± 7 min 33 s, p = 0.507), or major complications (2.43% vs 5.8%, p = 0.101). Radiation dose to patients was 84% lower in the sequential group (54.8 ± 51.8 mGy cm vs 352.6 ± 404 mGy cm, p < 0.0001). CONCLUSIONS: Sequential CT fluoroscopy-guided whole-body interventional procedures seems to be as safe, effective and fast as spiral guidance, while also yielding a significant decrease in the radiation dose to patients. KEY POINTS: • Sequential CT fluoroscopy and spiral acquisition are comparable in terms of safety, effectiveness and speed. • Procedural times are comparable despite an increased number of acquisitions in sequential fluoroscopy. • Radiation dose to patients is 84% lower in sequential fluoroscopy compared with spiral CT.


Asunto(s)
Fluoroscopía/métodos , Neoplasias/diagnóstico , Radiografía Intervencional/métodos , Tomografía Computarizada por Rayos X/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Curva ROC , Dosis de Radiación
7.
Opt Express ; 27(24): 35588-35599, 2019 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-31878728

RESUMEN

Fiber dosimeters have recently drawn much interest for measuring in vivo and in real time the dose of medical radiations. This paper presents the first miniaturized fiber dosimeter integrated at the end of a narrow 125 µm outer diameter optical fiber. Miniaturization is rendered possible by exploiting the concept of a leaky wave optical antenna for interfacing the scintillators and the fiber and by taking advantage of the low propagation loss of narrow silica fibers and high detection yield of single-pixel photon counters. Upon irradiation at 6 MV in air, our fiber probe leads to a linear detection response with a signal-to-noise ratio as high as 195. Although implemented with inorganic scintillators and fiber, our miniaturized fiber probe induces minimum screening effects on ionizing radiations over a negligible area (0.153 mm2). Our nano-optically driven approach may thus result in ultra-compact fiber dosimeters of negligible footprint in the radiotherapeutic processes, even with non-water equivalent fibers and scintillators. This opens new opportunities for a large panel of therapies relying on ionizing radiations (photons or charged particles).

8.
Palliat Med ; 32(1): 6-16, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28786339

RESUMEN

BACKGROUND: Ensuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking. AIM: To assess the number and characteristics of prisoners requiring palliative care in French prisons. DESIGN: A prospective, national survey collecting data over a 3-month period. SETTING/PARTICIPANTS: All healthcare units ( n = 190) providing care for prisoners in France. The prison population was 66,698 during the study period. Data collection concerned prisoners requiring end-of-life care, that is, with serious, advanced, progressive, or terminal illness and life expectancy <1 year. RESULTS: Estimated annual prevalence of ill prisoners requiring end-of-life care was 15.2 (confidence interval: 12.5-18.3) per 10,000 prisoners. The observed number of prisoners requiring palliative care ( n = 50) was twice as high as the expected age- and sex-standardized number based on the general population and similar to the expected number among persons 10 years older in the free community. In all, 41 of 44 (93%) of identified ill prisoners were eligible for temporary or permanent compassionate release, according to their practitioner. Only 33 of 48 (68%) of ill prisoners requested suspension or reduction in their sentence on medical grounds; half (16/33) received a positive answer. CONCLUSION: The proportion of prisoners requiring palliative care is higher than expected in the general population. The general frailty and co-existing conditions of prisoners before incarceration and the acceleration of these phenomena in prison could explain this increase in end-of-life situations among prisoners.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida/organización & administración , Enfermería de Cuidados Paliativos al Final de la Vida/estadística & datos numéricos , Cuidados Paliativos/organización & administración , Cuidados Paliativos/estadística & datos numéricos , Prisioneros/estadística & datos numéricos , Cuidado Terminal/organización & administración , Cuidado Terminal/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Encuestas y Cuestionarios , Enfermo Terminal/estadística & datos numéricos , Adulto Joven
9.
Eur J Pediatr ; 176(3): 301-309, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28058530

RESUMEN

The incidence of intussusception in infants varies around the world. The epidemiology of intussusception in France has never been prospectively studied. We performed a prospective observational study with systematic inclusion of all infants aged <1 year with suspected intussusception admitted to the emergency departments of the hospitals in the eastern region of France (98,000 live births per year), from 4/1/2008 to 3/31/2012. Cases were classified using the Brighton Collaboration classification. In total, 185 infants with suspected intussusception were included of which 169 were idiopathic intussusception. Among these 169 cases, 115 (68%) were classed as Brighton level 1 (confirmed cases). Overall incidence of intussusception over the 4 years of the study was 29.8 (95% CI 24.6-35.7) cases per 100,000 live births for level 1 and 37.5 (95% CI 31.7-44.2) cases per 100,000 live births for all cases (levels 1-4). Annual incidence rates of level 1 intussusception were as follows: 44 (95% CI 31.9-59.3), 30.9 (20.9-44.2), 21.7 (13.4-33.2) and 22.1 (13.7-33.8) per 100,000 live births in the 1st, 2nd, 3rd and 4th study years, respectively. CONCLUSION: The incidence rate of intussusception in the eastern part of France is comparable to that of other European countries. There was a significant trend towards a decrease in the incidence of intussusception. What is known • Intussusception is the most frequent causes of intestinal obstruction in infants and young children. Overall incidence of intussusception in infants aged <1 year varies widely around the world. No specific epidemiological studies have not been conducted in France on intussusception. What is new: • This prospective and multicenter study provides important information about the epidemiology of intussusception in infants in France over a period of 4 years.


Asunto(s)
Intususcepción/epidemiología , Enfermedad Aguda , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Francia/epidemiología , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Estudios Prospectivos , Sistema de Registros
10.
Neurobiol Learn Mem ; 132: 18-28, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-27131744

RESUMEN

The vast majority of people experience musical imagery, the sensation of reliving a song in absence of any external stimulation. Internal perception of a song can be deliberate and effortful, but also may occur involuntarily and spontaneously. Moreover, musical imagery is also involuntarily used for automatically completing missing parts of music or lyrics from a familiar song. The aim of our study was to explore the onset of musical imagery dynamics that leads to the automatic completion of missing lyrics. High-density electroencephalography was used to record the cerebral activity of twenty healthy volunteers while they were passively listening to unfamiliar songs, very familiar songs, and songs previously listened to for two weeks. Silent gaps inserted into these songs elicited a series of neural activations encompassing perceptual, attentional and cognitive mechanisms (range 100-500ms). Familiarity and learning effects emerged as early as 100ms and lasted 400ms after silence occurred. Although participants reported more easily mentally imagining lyrics in familiar rather than passively learnt songs, the onset of neural mechanisms and the power spectrum underlying musical imagery were similar for both types of songs. This study offers new insights into the musical imagery dynamics evoked by gaps of silence and on the role of familiarity and learning processes in the generation of these dynamics. The automatic and effortless method presented here is a potentially useful tool to understand failure in the familiarity and learning processes of pathological populations.


Asunto(s)
Percepción Auditiva/fisiología , Corteza Cerebral/fisiología , Electroencefalografía/métodos , Potenciales Evocados/fisiología , Imaginación/fisiología , Aprendizaje/fisiología , Música/psicología , Poesía como Asunto , Reconocimiento en Psicología/fisiología , Adulto , Femenino , Humanos , Masculino
11.
BMC Palliat Care ; 14: 61, 2015 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-26572617

RESUMEN

BACKGROUND: Little is known about what is at stake at a subjective level for the oncologists and the advanced cancer patients when they face the question whether to continue, limit or stop specific therapies. We studied (1) the frequency of such questioning, and (2) subjective determinants of the decision-making process from the physicians' and the patients' perspectives. METHODS: (1) All hospitalized patients were screened during 1 week in oncology and/or hematology units of five institutions. We included those with advanced cancer for whom a questioning about the pursuit, the limitation or the withholding of specific therapies (QST) was raised. (2) Qualitative design was based on in-depth interviews. RESULTS: In conventional units, 12.8 % of cancer patients (26 out of 202) were concerned by a QST during the study period. Interviews were conducted with all physicians and 21 advanced cancer patients. The timing of this questioning occurred most frequently as physicians estimated life expectancy between 15 days and 3 months. Faced with the most frequent dilemma (uncertain risk-benefit balance), physicians showed different ways of involving patients. The first two were called the "no choice" models: 1) trying to resolve the dilemma via a technical answer or a "wait-and-see" posture, instead of involving the patients in the questioning and the thinking; and 2), giving a "last minute" choice to the patients, leaving to them the responsibility of the decision. In a third model, they engaged early in shared reflections and dialogue about uncertainties and limits with patients, proxies and care teams. These schematic trends influenced patients' attitudes towards uncertainty and limits, as they were influenced by these ones. Individual and systemic barriers to a shared questioning were pointed out by physicians and patients. CONCLUSIONS: This study indicate to what extent these difficult decisions are related to physicians' and patients' respective and mutually influenced abilities to deal with and share about uncertainties and limits, throughout the disease trajectory. These insights may help physicians, patients and policy makers to enrich their understanding of underestimated and sensitive key issues of the decision-making process.


Asunto(s)
Conducta de Elección , Toma de Decisiones , Neoplasias/terapia , Cuidado Terminal/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Relaciones Médico-Paciente/ética , Estudios Prospectivos , Investigación Cualitativa , Cuidado Terminal/ética , Cuidado Terminal/psicología
12.
PeerJ ; 12: e17448, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38948229

RESUMEN

Intro: Electroencephalography (EEG) is a technique for measuring brain activity that is widely used in neuroscience research. Event-related potentials (ERPs) in the EEG make it possible to study sensory and cognitive processes in the brain. Previous reports have shown that aerobic exercise can have an impact on components of ERPs such as amplitude and latency. However, they focused on the measurement of ERPs after exercise. Objectives: The aim of this systematic review was to investigate the feasibility of measuring ERPs during cycling, and to assess the impact of cycling on ERPs during cycling. Methods: We followed the PRISMA guidelines for new systematic reviews. To be eligible, studies had to include healthy adults and measure ERPs during cycling. All articles were found using Google Scholar and by searching references. Data extracted from the studies included: objectives of ERP studies, ERP paradigm, EEG system, study population data, exercise characteristics (duration, intensity, pedaling cadence), and ERP and behavioral outcomes. The Cochrane Risk of Bias 2 tool was used to assess study bias. Results: Twenty studies were selected. The effect of cycling on ERPs was mainly based on a comparison of P3 wave amplitude between cycling and resting states, using an attentional task. The ERP paradigm most often used was the auditory oddball task. Exercise characteristics and study methods varied considerably. Discussion: It is possible to measure ERPs during cycling under conditions that are likely to introduce more artifacts, including a 3-h athletic exercise session and cycling outdoors. Secondly, no assessment of the effect of cycling on ERPs was possible, because the methods differed too widely between studies. In addition, the theories proposed to explain the results sometimes seemed to contradict each other. Although most studies reported significant results, the direction of the effects was inconsistent. Finally, we suggest some areas for improvement for future studies on the subject.


Asunto(s)
Ciclismo , Electroencefalografía , Potenciales Evocados , Humanos , Electroencefalografía/métodos , Ciclismo/fisiología , Potenciales Evocados/fisiología , Ejercicio Físico/fisiología , Encéfalo/fisiología
13.
Head Neck ; 46(5): 1136-1145, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38299429

RESUMEN

BACKGROUND: Autofluorescence spectroscopy is effective for noninvasive detection but underutilized in tissue with various pathology analyses. This study evaluates whether AFS can be used to discriminate between different types of laryngeal lesions in view of assisting in vocal fold surgery and preoperative investigations. METHODS: A total of 1308 spectra were recorded from 29 vocal fold samples obtained from 23 patients. Multiclass analysis was performed on the spectral data, categorizing lesions into normal, benign, dysplastic, or carcinoma. RESULTS: Through an appropriate selection of spectral components and a cascading classification approach based on artificial neural networks, a classification rate of 97% was achieved for each lesion class, compared to 52% using autofluorescence intensity. CONCLUSIONS: The ex vivo study demonstrates the effectiveness of AFS combined with multivariate analysis for accurate classification of vocal fold lesions. Comprehensive analysis of spectral data significantly improves classification accuracy, such as distinguishing malignant from precancerous or benign lesions.


Asunto(s)
Neoplasias Laríngeas , Laringe , Lesiones Precancerosas , Humanos , Pliegues Vocales/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Neoplasias Laríngeas/patología , Laringe/patología , Análisis Espectral
14.
Infect Dis Now ; 54(1): 104830, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37949172

RESUMEN

INTRODUCTION: Immunosuppressive drugs taken by transplant recipients may favor HPV infection at anogenital sites. HPV-type prevalence was studied in males and females before and after renal transplantation. PATIENTS AND METHODS: Anal, cervical and penile samples were taken from 62 patients before transplantation and from 41 patients after transplantation. HPV DNA was investigated using the INNO-LiPA HPV genotyping extra test and HPV-type distribution determined. RESULTS: Before transplantation, up to 30% of analyzed samples harbored HPV DNA, with the highest prevalence found in cervical specimens (60%). After transplantation, a trend toward HPV clearance was observed in females. By contrast, a trend toward incident infections by a wide variety of HPV genotypes at the penis and anal level was documented in men. CONCLUSION: High prevalence of HPV at anogenital sites was documented before and after renal transplantation. Immunosuppressive drugs taken after transplantation may impact HPV acquisition or reactivation, especially in males. Special attention should be paid in view of preventing HPV-associated diseases in this vulnerable population.


Asunto(s)
Trasplante de Riñón , Infecciones por Papillomavirus , Masculino , Humanos , Femenino , Infecciones por Papillomavirus/epidemiología , Trasplante de Riñón/efectos adversos , Papillomaviridae/genética , ADN
15.
BMC Sports Sci Med Rehabil ; 15(1): 98, 2023 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-37559143

RESUMEN

BACKGROUND: Cardiac rehabilitation is a key component of secondary prevention, but uptake is often low, and motivation to pursue exercise and lifestyle changes may be lacking in patients who have suffered from acute myocardial infarction (AMI). We explored the intentions of patients hospitalized for AMI regarding attendance at cardiac rehabilitation and the future pursuit of regular physical exercise at home. METHODS: We performed a qualitative study using semi-structured interviews. Eligible patients were those hospitalized for AMI in the cardiology unit of a large university hospital in Eastern France between 10/11/2021 and 7/3/2022, and who were deemed eligible for rehabilitation by the treating physician. Patients were interviewed before discharge. Interviews were transcribed and analysed by thematic analysis. We administered the Global Physical Activity Questionnaire (GPAQ) questionnaire to all participants. RESULTS: Of 17 eligible patients, 15 were interviewed, at which point saturation was reached. The majority were males (n = 13, 86%), median age 54 years (41-61). Three key themes emerged: Firstly, there is a mismatch between patients' perceptions of their physical activity and actual level of activity as assessed by objective tools. Second, cardiac rehabilitation is seen as a vector for information about the return to home after AMI. Third, regarding the intention to change lifestyle, there are persisting obstacles, drivers, fears and expectations. CONCLUSION: Patients with AMI often overestimate how physically active they are. Even close to discharge, patients have persisting informational needs, and many see cardiac rehabilitation as a means to obtain this information, rather than as a therapeutic intervention.

16.
Pharmaceutics ; 15(7)2023 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-37514111

RESUMEN

A major limitation in the current topical treatment strategies for inflammatory skin disorders is the inability to selectively target the inflamed site with minimal exposure of healthy skin. Atopic dermatitis is one of the most prevalent types of dermatitis. The use of polymeric nanoparticles for targeting inflamed skin has been recently proposed, and therefore the aim of this proof-of-concept clinical study was to investigate the skin penetration and deposition of polymeric biodegradable nanoparticles in the atopic dermatitis lesions and compare the data obtained to the deposition of the particles into the healthy skin or lesion-free skin of the atopic dermatitis patients. For that, fluorescent PLGA nanoparticles in sizes of approximately 100 nm were prepared and applied to the skin of healthy volunteers and the lesional and non-lesional skin of atopic dermatitis patients. Skin biopsies were examined using confocal laser scanning microscopy to track the skin deposition and depth of penetration of the particles. Immunohistochemistry was performed to investigate the alteration in tight-junction protein distribution in the different types of skin. Results have shown that nanoparticles were found to have higher deposition into the atopic dermatitis lesions with minimal accumulation in healthy or non-lesional skin. This has been primarily correlated with the impaired barrier properties of atopic dermatitis lesions with the reduced production of Claudin-1. It was concluded that polymeric nanoparticles offer a potential tool for selective drug delivery to inflamed skin with minimal exposure risk to healthy skin.

18.
Skin Res Technol ; 18(2): 251-8, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22093093

RESUMEN

BACKGROUND/AIMS: Different models of reconstructed skin are available, either to provide skin wound healing when this process is deficient, or to be used as an in vitro model. Nevertheless, few studies have focused on the mechanical properties of skin equivalent. Indeed, human skin is naturally under tension. Taking into account these features, the purpose of this work was to obtain a cellularized dermal equivalent (CDE), composed of collagen and dermal fibroblasts. METHODS: To counteract the natural retraction of CDE and to maintain it under tension, different biomaterials were tested. Selection criteria were biocompatibility, bioadhesion properties, ability to induce differentiation of fibroblasts into myofibroblasts and mechanical characterization, considering that of skin in vivo. These assays led to the selection of honeycomb of polyester. CDE constructed on this biomaterial was further characterized mechanically using tensile tests. RESULTS: The results showed that mechanical features of the obtained dermal equivalent, including myofibroblasts, were similar to skin in vivo. CONCLUSION: The original model of dermal equivalent presented herein may be a useful tool for clinical use and as an in vitro model for toxicological/pharmacological research.


Asunto(s)
Dermis/fisiología , Fibroblastos/fisiología , Ensayo de Materiales/métodos , Fenómenos Fisiológicos de la Piel , Piel Artificial , Actinas/fisiología , Adhesión Celular/fisiología , Diferenciación Celular/fisiología , Células Cultivadas , Dermis/citología , Estudios de Factibilidad , Fibroblastos/citología , Citometría de Flujo , Humanos , Concentración de Iones de Hidrógeno , Técnicas In Vitro , Poliésteres , Estrés Mecánico , Resistencia a la Tracción/fisiología
19.
Psychiatry Clin Neurosci ; 66(4): 344-52, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22624740

RESUMEN

AIMS: Several variables are able to influence the antidepressant effects of repetitive transcranial magnetic stimulation (rTMS), particularly the intensity of stimulation, which is generally expressed according to the resting motor threshold (RMT). The aim of our study was to investigate whether or not RMT changes during the treatment of resistant depression by rTMS and whether these fluctuations could alter treatment outcome. METHODS: Seventy-five inpatients suffering from unipolar or bipolar treatment-resistant depression and who had been antidepressant-free or taking a stable antidepressant drug and a daily dose of benzodiazepine for at least a month received a left prefrontal rTMS session once a day for 10 days at 10 Hz and 95% RMT. RESULTS: For the whole group, no significant fluctuation of RMT was observed between the first and the second week of rTMS treatment. However, RMT increased, decreased or remained constant throughout treatment depending on the patient. These RMT changes influenced the outcome of the 10 sessions concerning the severity of depressive and anxiety symptoms, measured by the Beck Depression Inventory and State Trait Anxiety, respectively. CONCLUSIONS: Our results justify calculating RMT regularly, and suggest that its variations play a role in treatment outcome.


Asunto(s)
Trastorno Depresivo Resistente al Tratamiento/terapia , Corteza Motora/fisiología , Corteza Prefrontal/fisiología , Estimulación Magnética Transcraneal/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Estimulación Magnética Transcraneal/métodos
20.
Front Hum Neurosci ; 16: 855778, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35601903

RESUMEN

The study of interbrain coupling in a group of people attending a concert together is a favorable framework to estimate group emotions and more precisely emotional connection between people sharing situations in the same environment. It offers the advantage of studying interactions at the group level. By recording the cerebral activity of people from an audience during a concert using electroencephalography, we previously demonstrated that the higher the emotions and the physically closer the people were, the more the interbrain synchrony (IBS) was enhanced. To further investigate the parameters that shaped inter-brain synchronization in this context, we now focus on the emotional dynamics of the group as a whole by identifying specific moments in the concert that evoked strong or weak emotions, as well as strong or weak emotional cohesion between individuals. We demonstrated that audience interbrain synchrony is mainly associated with experiencing high musical pleasure and that the group emotional cohesion can enhance IBS, but alone is not the major parameter that shapes it in this context.

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