Liste des publications scientifiques du CHU de Clermont-Ferrand

Cette liste prend en compte l'ensemble des publications scientifiques du CHU référencées sur PubMed de 1973 au 31.12.2020

Auteurs : Bertrand, LR; Abdallah, M; Espinel, Y; Buc, E; Bartoli, A ; et al.

Revue : Surgical endoscopy - ISSN : 1432-2218 - NLMID : 8806653
Date de Publication : Décembre 2020
Vol. : 34 Numéro 12 Pages : 5642-5648

Résumé : Previous work in augmented reality (AR) guidance in monocular laparoscopic hepatectomy requires the surgeon to manually overlay a rigid preoperative model onto a laparoscopy image. This Mai be fairly inaccurate because of significant liver deformation. We have proposed a technique which overlays a deformable preoperative model semi-automatically onto a laparoscopic image using a new software called Hepataug. The aim of this study is to show the feasibility of Hepataug to perform AR with a deformable model in laparoscopic hepatectomy.We ran Hepataug during the procedures, as well as the usual means of laparoscopic ultrasonography (LUS) and visual inspection of the preoperative CT or MRI. The primary objective was to assess the feasibility of Hepataug, in terms of minimal disruption of the surgical workflow. The secondary objective was to assess the potential benefit of Hepataug, by subjective comparison with LUS.From July 2017 to March 2019, 17 consecutive patients were included in this study. AR was feasible in all procedures, with good correlation with LUS. However, for 2 patients, LUS did not reveal the location of the tumors. Hepataug gave a prediction of the tumor locations, which was confirmed and refined by careful inspection of the preoperative CT or MRI.Hepataug showed a minimal disruption of the surgical workflow and can thus be feasibly used in real hepatectomy procedures. Thanks to its new mechanism of semi-automatic deformable alignment, Hepataug also showed a good agreement with LUS and visual CT or MRI inspection in subsurface tumor localization. Importantly, Hepataug yields reproducible results. It is easy to use and could be deployed in any existing operating room. Nevertheless, comparative prospective studies are needed to study its efficacy.

Mots clés auteurs : /Augmented reality/Deformable 3D model/Laparoscopy/Liver/Overlay/Resection

Auteurs : Dulai, PS; Amiot, A; Peyrin-Biroulet, L; Carbonnel, F; , ; et al.

Revue : Alimentary pharmacology & therapeutics - ISSN : 1365-2036 - NLMID : 8707234
Date de Publication : Mars 2020
Vol. : 51 Numéro 5 Pages : 553-564

Résumé : A clinical decision support tool (CDST) has been validated for predicting treatment effectiveness of vedolizumab (VDZ) in Crohn's disease.To assess the utility of this CDST for predicting exposure-efficacy and disease outcomes.Using data from three independent datasets (GEMINI, GETAID and VICTORY), we assessed clinical remission rates and measured VDZ exposure, rapidity of onset of action, response to dose optimisation and progression to surgery by CDST-defined response groups (low, intermediate and high).A linear relationship existed between CDST-defined groups, measured VDZ exposure, rapidity of onset of action and efficacy in GEMINI through week 52 (P < 0.001 at all time points across three CDST-defined groups). In GETAID, CDST predicted differences in clinical remission at week 14 (AUC = 0.68) and rapidity of onset of action (P = 0.04) between probability groups. The high-probability patients did not benefit from shortening of infusion intervals, and differences in onset of action between the high-intermediate and low-probability groups within GETAID were no longer significant when including low-probability patients who received a week 10 infusion. CDST predicted a twofold increase in surgery risk over 12 months of VDZ therapy among low- to intermediate-probability vs high-probability patients (adjusted HR 2.06, 95% CI 1.33-3.21).We further extended the clinical utility of a previously validated VDZ CDST, which accurately predicts at baseline exposure-efficacy relationships and rapidity of onset of action and could be used to help identify patients who would most benefit from interval shortening and those most likely to require surgery while on active therapy.

Mesh : Adult|Algorithms|Antibodies, Monoclonal, Humanized/therapeutic use|Calibration|Cohort Studies|Crohn Disease/drug therapy/epidemiology|Decision Support Systems, Clinical|Drug Monitoring/methods/standards|Female|Gastrointestinal Agents/therapeutic use|Humans|Male|Middle Aged|Patient Selection|Treatment Outcome|Young Adult

Auteurs : Munoz-Sanchez, ML; Linas, N; Decerle, N; Hennequin, M; Cousson, PY ; et al.

Revue : International journal of environmental research and public health - ISSN : 1660-4601 - NLMID : 101238455
Date de Publication : Août 2020
Vol. : 17 Numéro 17

Résumé : A higher chance of carrying out a successful full pulpotomy Mai depend on whether the coronal restoration can be completed within a single appointment. The development of chairside CAD/CAM (Computer Aided Design and Manufacturing) technology has made it possible to carry out indirect restoration of endodontically treated teeth in a single session. This study aimed to evaluate the long-term outcome of a full pulpotomy with Biodentine™ immediately covered with a chairside CAD/CAM endocrown on teeth affected by pulpitis and deep carious lesions. The investigation involved a cohort of 30 molars that were treated by pulpotomy and CAD/CAM endocrown. Clinical and radiological examinations were scheduled at 1, 6, and 12 months postoperatively. Overall, all treatments were effective at any time during the follow-up. The results of this study need to be confirmed with a longer-term follow-up to allow for comparison with the literature. This original combination of endodontic and restorative treatments provides an Endo-prosthetic continuum in a single session, with the objective of long-term success in terms of tooth health.

Mesh : Computer-Aided Design|Humans|Molar|Probability|Pulpitis/therapy|Pulpotomy/methods

Mots clés auteurs : /CAD/CAM restoration/chairside/deep carious lesions/full pulpotomy/pulpitis

Auteurs : Amarenco, P; Kim, JS; Labreuche, J; Bruckert, E; , ; et al.

Revue : The New England journal of medicine - ISSN : 1533-4406 - NLMID : 255562
Date de Publication : Janvier 2020
Vol. : 382 Numéro 1 Pages : 9

Résumé : The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied.In this parallel-group trial conducted in France and South Korea, we randomly assigned patients with ischemic stroke in the previous 3 months or a TIA within the previous 15 days to a target LDL cholesterol level of less than 70 mg per deciliter (1.8 mmol per liter) (lower-target group) or to a target range of 90 mg to 110 mg per deciliter (2.3 to 2.8 mmol per liter) (higher-target group). All the patients had evidence of cerebrovascular or coronary-artery atherosclerosis and received a statin, ezetimibe, or both. The composite primary end point of major cardiovascular events included ischemic stroke, myocardial infarction, new symptoms leading to urgent coronary or carotid revascularization, or death from cardiovascular causes.A total of 2860 patients were enrolled and followed for a median of 3.5 years; 1430 were assigned to each LDL cholesterol target group. The mean LDL cholesterol level at baseline was 135 mg per deciliter (3.5 mmol per liter), and the mean achieved LDL cholesterol level was 65 mg per deciliter (1.7 mmol per liter) in the lower-target group and 96 mg per deciliter (2.5 mmol per liter) in the higher-target group. The trial was stopped for administrative reasons after 277 of an anticipated 385 end-point events had occurred. The composite primary end point occurred in 121 patients (8.5%) in the lower-target group and in 156 (10.9%) in the higher-target group (adjusted hazard ratio, 0.78; 95% confidence interval, 0.61 to 0.98; P?=?0.04). The incidence of intracranial hemorrhage and newly diagnosed diabetes did not differ significantly between the two groups.After an ischemic stroke or TIA with evidence of atherosclerosis, patients who had a target LDL cholesterol level of less than 70 mg per deciliter had a lower risk of subsequent cardiovascular events than those who had a target range of 90 mg to 110 mg per deciliter. (Funded by the French Ministry of Health and others; Treat Stroke to Target number, NCT01252875.).

Mesh : Adult|Aged|Anticholesteremic Agents/adverse effects/therapeutic use|Atherosclerosis/complications/drug therapy|Brain Ischemia/drug therapy|Cardiovascular Diseases/mortality/prevention & control|Cholesterol, LDL/blood|Drug Therapy, Combination|Ezetimibe/therapeutic use|Female|Humans|Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use|Intention to Treat Analysis|Ischemic Attack, Transient/complications/drug therapy|Kaplan-Meier Estimate|Male|Middle Aged|Stroke/blood/drug therapy

Auteurs : Decerle, N; Cousson, PY; Nicolas, E; Hennequin, M ;

Revue : International journal of environmental research and public health - ISSN : 1660-4601 - NLMID : 101238455
Date de Publication : Octobre 2020
Vol. : 17 Numéro 19

Résumé : Access to dental treatment could be difficult for some patients due to dental phobia or anxiety, cognitive or sensorial disabilities, systemic disorders, or social difficulties. General anesthesia (GA) was often indicated for dental surgery, and there is almost no available data on adapted procedures and materials that can be applied during GA for maintaining functional teeth on the arches and limiting oral dysfunctions. This study evaluates changes in oral health-related quality of life and mastication in a cohort of uncooperative patients treated under GA according to a comprehensive and conservative dental treatment approach. Dental status, oral health-related quality of life, chewed bolus granulometry, kinematic parameters of mastication, and food refusals were evaluated one month preoperatively (T0), and then one month (T1) and six months post-operatively (T2). One hundred and two adult patients (mean age ± SD: 32.2 ± 9.9 years; range: 18-57.7) participated in the preoperative evaluation, 87 were treated under GA of which 36 participated in the evaluation at T1 and 15 were evaluated at T2. Preoperative and postoperative data comparisons demonstrated that oral rehabilitation under GA helped increase chewing activity and oral health-related quality of life. The conditions for providing dental treatment under GA could be arranged to limit dental extractions in uncooperative patients.

Mesh : Adaptation, Physiological|Adolescent|Adult|Anesthesia, General|Dental Caries|Humans|Mastication|Middle Aged|Oral Health|Quality of Life|Young Adult

Mots clés auteurs : /access to care/general anesthesia/mastication/oral health related quality of life/oral rehabilitation