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Anaïs Lemoine AnneSophie Colas Sbastien Le Christophe Delacourt Patrick Tounian Guillaume Lezmi 《Clinical and translational allergy》2022,12(2)
BackgroundFood protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, and age of tolerance depending on the country of origin. We aimed at describing the characteristics of a French population of children with FPIES, and define risk factors for failure during challenge.MethodsData from 179 children who were referred for FPIES in two pediatric tertiary centers between 2014 and 2020 were retrospectively collected. The diagnosis of FPIES was based on international consensus guidelines. Clinical characteristics, culprit food, and age at resolution were assessed. Tolerance was defined as no adverse reaction after OFC or accidental exposure.ResultsIn the 192 described FPIES, the age at first symptoms was 5.8 months old. The main offending foods were cow''s milk (60.3%), hen''s egg (16.2%), and fish (11.7%). Single FPIES was observed in 94.4% and multiple FPIES in 5.6% of cases. The age at resolution of FPIES was 2.2 years old, and resolution occurred later for fish than for milk (2.9 years vs. 2.0, p = 0.01). Severe acute FPIES was a risk factor for delayed resolution (RR: 3.3 [1.2–9.2]), but not IgE sensitization. Performing a food challenge within 12 months after the first reaction increased the risk of failure (OR: 2.6 [1.1–6.6]).ConclusionIn this French cohort of children with FPIES, the main culprit foods were ubiquitous. Rice, oat, and soy were rarely or not involved. Multiple FPIES was infrequent. Our data confirmed the overall good prognosis of FPIES, the later resolution of FPIES to fish and in the case of severe acute FPIES. 相似文献
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Azoulay D Lucidi V Andreani P Maggi U Sebagh M Ichai P Lemoine A Adam R Castaing D 《Journal of the American College of Surgeons》2006,202(2):203-211
BACKGROUND: Two randomized prospective studies suggested that ischemic preconditioning (IP) protects the human liver against ischemia-reperfusion injury after hepatectomy performed under continuous clamping of the portal triad. The primary goal of this study was to determine whether IP protects the human liver against ischemia-reperfusion injury after hepatectomy under continuous vascular exclusion with preservation of the caval flow. STUDY DESIGN: Sixty patients were randomly divided into two groups: with (n=30; preconditioning group) and without (n=30; control group) IP (10 minutes of portal triad clamping and 10 minutes of reperfusion) before major hepatectomy under vascular exclusion of the liver preserving the caval flow. Serum concentrations of aspartate transferase, alanine transferase, glutathione-S-transferase, and bilirubin and prothrombin time were regularly determined until discharge and at 1 month. Morbidity and mortality were determined in both groups. RESULTS: Peak postoperative concentrations of aspartate transferase were similar in the groups with and without IP (851 +/- 1,733 IU/L and 427 +/- 166 IU/L respectively, p=0.2). A similar trend toward a higher peak concentration of alanine transferase and glutathione-S-transferase was indeed observed in the preconditioning group compared with the control group. Morbidity and mortality rates and lengths of ICU and hospitalization stays were similar in both groups. CONCLUSIONS: IP does not improve liver tolerance to ischemia-reperfusion after hepatectomy under vascular exclusion of the liver with preservation of the caval flow. This maneuver does not improve postoperative liver function and does not affect morbidity or mortality rates. The clinical use of IP through 10 minutes of warm ischemia in this technique of hepatectomy is not currently recommended. 相似文献
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Surgical management of gallstones in cirrhotic patients 总被引:8,自引:0,他引:8
Among the cirrhotic patients admitted to our department, 64 (17 percent) were found to have cholelithiasis. In 14 patients (22 percent), cholelithiasis caused cholecystitis, obstructive jaundice, or biliary pain. These 14 patients were operated on and underwent cholecystectomy. There was one postoperative complication (gastrointestinal bleeding from esophageal varices) and one death (due to acute respiratory failure). In 50 patients (78 percent) cholelithiasis was asymptomatic. Ten of the 50 patients died from liver failure and the stones were discovered at necropsy. Seven of the patients had radiographically demonstrated stones that were not operated on. They are alive at the present time, more than 2 years later. In the remaining 33 patients, the stones were discovered during portasystemic shunt procedures. In these patients, cholelithiasis was systematically treated by cholecystectomy (8 patients) or cholecystolithotomy (25 patients). Postoperative mortality and morbidity rates were not different in these 33 patients when compared with the rates in 170 patients who underwent portal surgery alone during the same period. Our results confirm the high incidence of cholelithiasis in cirrhotic patients. Complications of gallstones are not frequent but require an emergency operation that carries a high risk in these patients. On the other hand, elective surgical treatment of asymptomatic cholelithiasis at the time of portal diversion does not bear any peculiar risk. In such a situation, cholecystolithotomy is easier and probably safer than cholecystectomy. 相似文献
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Sylvain Auriol Véronique Pagot-Mathis Laurence Mahieu Claudia Lemoine André Mathis 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2008,246(10):1383-1389
PURPOSE: To assess the efficacy and safety of a heavy silicone oil (Densiron 68(R)), a mixture of perfluorohexyloctane (F(6)H(8)) with silicone oil as temporary internal tamponade in selected retinal detachments treated with large inferior retinectomy. METHODS: Complicated retinal detachments with severe posterior and anterior proliferative vitreoretinopathy (PVR) were included in this study. In all cases, a large inferior retinectomy involving the inferior quadrants was performed. Densiron 68(R) was injected at the end of surgery after perfluorocarbon injection. A minimum follow-up of 6 months was required in order to be included in this retrospective study. RESULTS: Twenty-seven patients were operated on with a mean follow-up of 57.5 weeks. Twenty-three patients presented a posterior PVR > CP6 and 26 patients an anterior PVR > CA5. Heavy silicone oil was removed in 19 patients after a mean follow-up of 14 weeks. At the 4-week follow-up visit, only one retinectomy was reopened by a recurrent inferior retinal detachment with PVR CP3. Finally, anatomical success was achieved in 25 of the 27 patients (92.5%) after Densiron 68(R) removal at the last follow-up. The main adverse effect was inflammatory reaction with fibrin accumulation in the anterior chamber (40.7%). CONCLUSION: Densiron 68(R) appeared to be an efficient endotamponade agent in selected retinal detachments treated with large inferior retinectomy. It avoids fluid accumulation under the inferior retina and seems to limit the rate of inferior retinectomy reopening. 相似文献
48.
Inge Peerlinck Saeid Amini-Nik Robin K Phillips Richard Iggo Nicholas R Lemoine Sabine Tejpar Georges Vassaux 《Clinical cancer research》2008,14(19):6187-6192
PURPOSE: Constitutive activation of the Wnt signaling pathway is a hallmark of many cancers and has been associated with familial and sporadic desmoid tumors. The aim of the present study is to assess the therapeutic potential of oncolytic adenoviruses selectively replicating in cells in which the Wnt signaling pathway is active on primary cells from desmoid tumors. EXPERIMENTAL DESIGN: Primary cells extracted from familial (n = 3) or sporadic (n = 3) desmoid tumors were cultured short term. Cancer cell survival and viral replication were measured in vitro upon infection with two different oncolytic adenoviruses targeting a constitutive activation of the Wnt signaling pathway. Adenoviral infectivity was also assessed. RESULTS: Although cells extracted from one sporadic desmoid tumor responded very well to the oncolytic action of the adenoviruses (<20% of viable cells upon infection at a multiplicity of infection of 10), cells from two tumor samples were totally resistant to the viral action. Cells from the remaining samples showed intermediate sensitivity to the oncolytic viruses. These effects were correlated to the level of infectivity of the cells. Finally, in responder cells, evidences of viral replication was observed. CONCLUSIONS: Our experimental data suggest that the response of desmoid tumor cells to oncolytic adenovirus is neither correlated to the type of mutation activating the Wnt signaling pathway nor to the familial or sporadic nature of the tumor. In addition, they highlight the variability of infectivity of individual tumors and predict a great variability in the response to oncolytic adenoviruses. 相似文献
49.
Daraï E Gompel A Deval B Laplace C Lemoine A Labeyrie E Neu AM Poitout P 《Gynécologie, obstétrique & fertilité》2000,28(3):198-204
Use of hormonal replacement therapy after treatment of ovarian or endometrial cancer remains a matter of debate. Novel adjuvant therapies tend to increase the survival of these patients, who are exposed to risk factors of hormonal deficiency subsequent to primary therapy. Therefore, the aims of the present review of literature was to analyse epidemiologic and clinical parameters on behalf on hormonal replacement therapy in this population. 相似文献
50.