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1.
ASAIO J ; 70(3): 185-192, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-37856703

ABSTRACT

Hemodynamic instability in postresuscitation syndrome worsens survival and neurological outcomes. Venoarterial extracorporeal membrane oxygenation (VA ECMO) for refractory cardiac arrest might improve outcomes. Hemodynamical support under VA ECMO relies on norepinephrine and crystalloids. The present work aims to assess the effects of albumin (ALB) infusion in a swine model of ischemic refractory cardiac arrest implanted by VA ECMO. Cardiac arrest was performed in 18 pigs and VA ECMO was initiated after 30 minutes cardiopulmonary resuscitation (CPR). Pigs were randomly assigned to standard care (norepinephrine + crystalloids) versus ALB group (ALB + standard care). Hemodynamical assessments were performed over 6 hours. Severe hypoalbuminemia was observed in the control group and could be reversed with ALB infusion. Total crystalloid load was significantly reduced with ALB infusion (1,000 [1,000-2,278] ml vs. 17,000 [10,000-19,000] ml, ALB versus control group, respectively, p < 0.001). There was no significant impact with regard to lactate clearance (29.16% [12.5-39.32] and 10.09% [6.78-29.36] for control versus ALB groups, respectively, p = 0.185), sublingual capillary microvascular parameters, or cerebral near-infrared spectrometer (NIRS) values. Compared to standard care, ALB infusion was highly effective in reducing fluid loading in a porcine model of postresuscitation syndrome after refractory cardiac arrest treated with VA ECMO.


Subject(s)
Cardiopulmonary Resuscitation , Extracorporeal Membrane Oxygenation , Heart Arrest , Animals , Heart Arrest/therapy , Lung , Norepinephrine , Swine
2.
Endoscopy ; 55(9): 785-795, 2023 09.
Article in English | MEDLINE | ID: mdl-37137331

ABSTRACT

BACKGROUND: Liver cirrhosis and esophageal cancer share several risk factors, such as alcohol intake and excess weight. Endoscopic resection is the gold standard treatment for superficial tumors. Portal hypertension and coagulopathy may increase the bleeding risk in these patients. This study aimed to assess the safety and efficacy of endoscopic resection for early esophageal neoplasia in patients with cirrhosis or portal hypertension. METHODS: This retrospective multicenter international study included consecutive patients with cirrhosis or portal hypertension who underwent endoscopic resection in the esophagus from January 2005 to March 2021. RESULTS: 134 lesions in 112 patients were treated, including by endoscopic submucosal dissection in 101 cases (75 %). Most lesions (128/134, 96 %) were in patients with liver cirrhosis, with esophageal varices in 71 procedures. To prevent bleeding, 7 patients received a transjugular intrahepatic portosystemic shunt, 8 underwent endoscopic band ligation (EBL) before resection, 15 received vasoactive drugs, 8 received platelet transfusion, and 9 underwent EBL during the resection procedure. Rates of complete macroscopic resection, en bloc resection, and curative resection were 92 %, 86 %, and 63 %, respectively. Adverse events included 3 perforations, 8 delayed bleedings, 8 sepsis, 6 cirrhosis decompensations within 30 days, and 22 esophageal strictures; none required surgery. In univariate analysis, cap-assisted endoscopic mucosal resection was associated with delayed bleeding (P = 0.01). CONCLUSIONS: In patients with liver cirrhosis or portal hypertension, endoscopic resection of early esophageal neoplasia appeared to be effective and should be considered in expert centers with choice of resection technique, following European Society of Gastrointestinal Endoscopy guidelines to avoid undertreatment.


Subject(s)
Esophageal Neoplasms , Esophageal and Gastric Varices , Hypertension, Portal , Humans , Gastrointestinal Hemorrhage/prevention & control , Hypertension, Portal/complications , Hypertension, Portal/surgery , Endoscopy , Esophageal Neoplasms/complications , Esophageal Neoplasms/surgery , Esophageal Neoplasms/pathology , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/surgery , Liver Cirrhosis/complications , Treatment Outcome
3.
J Bone Miner Metab ; 41(1): 105-112, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36418588

ABSTRACT

INTRODUCTION: The objectives were to evaluate bone fragility on computed tomography (CT) in patients with obesity before and 2 years after bariatric surgery and to identify risk factors for a decrease in the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1). MATERIALS AND METHODS: Patients with obesity who underwent bariatric surgery and CT before and 2 years (± 6 months) after bariatric surgery were included. SBAC-L1 was measured on CT with a fracture threshold at 145 HU. RESULTS: 78 patients were included, 85.9% women, mean age of 48.5 years (± 11.4); the mean BMI was 46.2 kg/m2 (± 7) before surgery and 29.8 kg/m2 (± 6.7) 2 years after surgery. There was a significant change in SBAC-L1 2 years after surgery (p = 0.037). In multivariate analysis, the risk factors for having an SBAC-L1 ≤ 145HU 2 years after bariatric surgery in those with an SBAC-L1 > 145HU before surgery were age and sex, with men and older patients having a higher risk (OR 32.6, CI 95% [1.86-568.77], and OR 0.85, CI 95% [0.74-0.98], respectively). CONCLUSION: SBAC-L1 was significantly lower two years after bariatric surgery. Men sex and older patients were the risk factors for having an SBAC-L1 below the fracture threshold 2 years after surgery.


Subject(s)
Bariatric Surgery , Fractures, Bone , Osteoporosis , Spinal Fractures , Male , Humans , Female , Middle Aged , Osteoporosis/complications , Absorptiometry, Photon/methods , Spinal Fractures/etiology , Retrospective Studies , Tomography, X-Ray Computed/methods , Fractures, Bone/complications , Lumbar Vertebrae/diagnostic imaging , Bariatric Surgery/adverse effects , Obesity/surgery , Obesity/complications , Bone Density
4.
J Nucl Cardiol ; 30(3): 1043-1049, 2023 06.
Article in English | MEDLINE | ID: mdl-36123566

ABSTRACT

Somatostatin receptors are overexpressed by inflammatory cells but not by cardiac cells, under normal conditions. This study assesses the detection of acute myocarditis by the ECG-triggered digital-PET imaging of somatostatin receptors (68Ga-DOTATOC-PET), as compared to Cardiac Magnetic Resonance (CMR) imaging, which is the reference diagnostic method in this setting. METHODS: Fourteen CMR-defined acute myocarditis patients had a first 15-minutes ECG-triggered 68Ga-DOTATOC PET recording, 4.4 ± 3.0 days from peak troponin, and 10 had a second 4.3 ± 0.3 months later. Myocardial/blood SUVmax ratio was analyzed relative to the normal upper limit of 2.18, which had been previously determined from oncology 68Ga-DOTATOC-PET recordings of patients with a similar age range as the myocarditis patients. RESULTS: An increased myocardial 68Ga-DOTATOC uptake relative to blood activity was invariably observed during the acute phase. SUVmax ratio exceeded 2.18 in all patients during the acute phase but also in 3/10 patients at 4-months, at a time when there were no more signs of active inflammation on CMR. A residual myocardial 68Ga-DOTATOC uptake was still observed on all gated-PET cine loops at 4-months. CONCLUSION: These preliminary results suggest that 68Ga-DOTATOC ECG-triggered digital-PET may be as sensitive as CMR at detecting myocarditis during the acute phase and more sensitive at later stages.


Subject(s)
Myocarditis , Organometallic Compounds , Humans , Receptors, Somatostatin , Gallium Radioisotopes , Positron-Emission Tomography/methods , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy , Electrocardiography
5.
Front Psychiatry ; 13: 959347, 2022.
Article in English | MEDLINE | ID: mdl-36465284

ABSTRACT

The impact of regular cannabis use on retinal function has already been studied using flash (fERG) and pattern (PERG) electroretinogram. Delayed ganglion and bipolar cells responses were observed as showed by increased peak time of PERG N95 and fERG b-wave recorded in photopic condition. Hypoactivity of amacrine cells was also showed by decreased amplitudes of oscillatory potentials (OPs). However, it is unknown how these retinal anomalies evolve according to the level of cannabis use in cannabis users. The aim of this study was to longitudinally assess the retinal function during a treatment aiming to reduce cannabis use. We recorded PERG and fERG in 40 regular cannabis users receiving either an 8 weeks mindfulness-based relapse prevention program or an 8 weeks treatment-as-usual therapy. ERGs were recorded before treatment, at the end of it, and 4 weeks afterward. We found reduced peak times in PERG N95 and fERG b-wave (p = 0.032 and p = 0.024: Dunn's post-hoc test) recorded at week 8 and increased amplitudes in OP2 and OP3 (p = 0.012 and p = 0.030: Dunn's post-hoc test) recorded at week 12 in users with decreased cannabis use. These results support variations of retinal anomalies with the level of cannabis use, implying that reduction of cannabis use could restore retinal function in regular users.

6.
Healthcare (Basel) ; 10(11)2022 Oct 28.
Article in English | MEDLINE | ID: mdl-36360494

ABSTRACT

Following COVID-19 infection, many patients suffer from long-lasting symptoms that may greatly impair their quality of life. Persisting dyspnea and other functional respiratory complaints can evoke hyperventilation syndrome (HVS) as a putative contributor to long-COVID presentation in COVID-19 survivors. We aimed to assess the possible relationship between HVS and previous acute COVID-19 infection. We designed a cross-sectional, single-center study, including all patients consecutively referred to our Lung Function and Exercise Testing Department between January and June 2021. Participants completed a systematic Nijmegen Questionnaire, a modified Medical Research Council dyspnea scale assessment, a post-COVID screening questionnaire, and performed a standardized lung function test. The population was divided according to HVS diagnosis, defined as a Nijmegen score of > 23/64. The occurrence of previous COVID-19 infection was compared according to the Nijmegen score after adjustment for potential confounders by multivariate logistic regression. In total, 2846 patients were included: 1472 men (51.7%) with a mean age of 56 (±16.6) years. A total of 455 patients (16%) declared a previous SARS-CoV-2 infection, and 590 patients presented a positive score (>23/64) in the Nijmegen Questionnaire (20.7%). Compared with COVID-19-free patients, there was an increased occurrence of HVS+ in cases of COVID-19 infection that did not require hospitalization (aOR = 1.93 [1.17−3.18]). The results of this large-scale, cross-sectional study suggest an association between HVS diagnosis and a history of COVID-19 disease in patients who were not hospitalized.

7.
J Scleroderma Relat Disord ; 7(3): 224-233, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36211200

ABSTRACT

Background: A higher risk of osteoporotic fracture was described in systemic sclerosis patients than in healthy patients. Objective: To evaluate the relation between osteoporotic fracture risk measured by the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1) on computed tomography (CT) scan and the presence of ectopic calcifications: vascular, valvular and spinal. Methods: This monocentric retrospective study was performed on patients followed between 2000 and 2014 at Nancy University Hospital. Systemic sclerosis patients, according to ACR/EULAR 2013 criteria, followed from 2000 to 2014 and who underwent, during their follow-up, a CT including the first lumbar vertebra were included. The SBAC-L1 was measured with a threshold set at 145 Hounsfield units (HU). Vascular and spinal calcifications were studied on CT. For vascular calcifications, the Agatston score was used. Valvular calcifications were studied on echocardiography. Results: A total of 70 patients were included (mean age: 62.3 (±15.6) years, women 88.5%). The mean SBAC-L1 was 157.26 (±52.1) HU, and 35 patients (50%) presented an SBAC-L1 ⩽ 145 HU. The reproducibility of the calcification evaluation was good, with kappa coefficients varying between 0.63 and 1. In univariate analysis, spinal and vascular calcifications were associated with an SBAC-L1 ⩽ 145 HU, with ORs of 13.6 (1.6-113.3) and 8 (95%CI: 2.5-25.5), respectively. In multivariate analysis, the SBAC-L1 was not associated with the presence of any ectopic calcifications. The SBAC-L1 decreased with age (p = 0.0001). Conclusion: Patients with systemic sclerosis with an SBAC-L1 ⩽ 145 HU were older, but they did not have more ectopic calcification. Trial registration: The ethics committee of Nancy Hospital agreed with this study (referral file number 166). This study was designed in accordance with the general ethical principles outlined in the Declaration of Helsinki.

8.
J Plast Reconstr Aesthet Surg ; 75(12): 4403-4409, 2022 12.
Article in English | MEDLINE | ID: mdl-36283927

ABSTRACT

INTRODUCTION: Axillary and inguinal lymph node dissection (LND) are performed in metastatic skin tumors with several local complications, such as lymphorrhea, lymphoceles, and lymphedema. The purpose of this study is to determine whether negative pressure wound therapy (NPWT) applied as a preventive measure could improve outcomes. MATERIALS AND METHODS: A monocentric study included patients who underwent axillary or inguinal LND from May 2010 to March 2020, with a retrospective evaluation of prospectively collected data. Patients were divided into two groups: the conventional wound care (CWC) and the NPWT groups. Patients were systematically reviewed at D7, D30, and at 1 year postoperative, and data regarding lymphorrhea, lymphoceles, and lymphedema were collected. RESULTS: A total of 109 axillary and inguinal LND were performed. NPWT was applied on 68 LND and CWC on 41 LND. The variables, diabetes, smoking, gender, associated treatments, and primary pathology (melanoma, squamous cell carcinoma, or Merkel tumors) were similar in both groups. Analyses have shown a significant difference in the rate of scar disunion during the first month between the two groups (p=0.045 between D1 and D7; p=0.011 between D8 and D30), as well as the presence of lymphorrhea (p=0.000 between D1 and D7; p=0.002 between D8 and D30). The rate of lymphoedema was significantly reduced in the NPWT group versus CWC (p=0.000 between D8 and D30; p=0.034 between D31 and 1 year). CONCLUSION: NPWT reduces local complications (scar disunion, lymphorrhea, and lymphedema) during the first year following LND in the management of node metastatic skin tumors.


Subject(s)
Lymphatic Diseases , Lymphedema , Lymphocele , Negative-Pressure Wound Therapy , Skin Neoplasms , Humans , Lymphocele/etiology , Retrospective Studies , Cicatrix/complications , Lymph Node Excision/adverse effects , Skin Neoplasms/surgery , Lymphedema/prevention & control , Lymphedema/complications , Lymph Nodes
9.
J Clin Med ; 11(20)2022 Oct 17.
Article in English | MEDLINE | ID: mdl-36294422

ABSTRACT

Remote photoplethysmography imaging (rPPGc) is a new method measuring essential parameters, such as heart rate (HR), which uses a video camera during teleconsultation. Our work aimed to evaluate the accuracy of such remote measurements compared with existing contact point measurement methods in real-life clinical settings. The prospective hospital-based study recruited 1045 patients who required a pulmonary function test. For each patient, measurements of HR using a standard electrocardiogram acquisition system (gold standard) were carried out concomitantly with the measurements made by the rPPGc system (Caducy v1.0.0) taken within a 60 s timeframe. Age, gender, and skin phototype were collected. We performed an intraclass coefficient correlation (ICC) and Bland-Altman plotting to determine the accuracy and precision of the rPPGc algorithm readings. We achieved measurement of HR using the two methods in 963 patients. The ICC measured at a 60 s timeframe, and when we compared the rPPGc with the gold standard, it had a 95% confidence interval (CI95) value of 0.886 [0.871:0.899]. In all, 94.6% (n = 911) patients showed promising results with a CI95 in Bland-Altman plotting. Fifty-two measurements were discordant, and further analysis established the method's accuracy at 96.2%. Our results described a good accuracy and correlation between the rPPGc system and the gold standard, thus paving the way for more precise care via telemedicine.

10.
J Clin Med ; 11(20)2022 Oct 17.
Article in English | MEDLINE | ID: mdl-36294434

ABSTRACT

The primary objective was to evaluate bone fragility prevalence on dual X-ray absorptiometry (DXA) and computed tomography (CT) in patients with severe obesity. The secondary objective was to evaluate the risk factors for bone fragility. This monocentric study was conducted in patients with grade 2 and 3 obesity. Bone mineral density (BMD) and T-score were studied on DXA, and the scanographic bone attenuation coefficient of L1 (SBAC-L1) was measured on CT. Among the 1386 patients included, 1013 had undergone both DXA and CT within less than 2 years. The mean age was 48.4 (±11.4) years, 77.6% were women, and the mean BMI was 45.6 (±6.7) kg/m². Eight patients (0.8%) had osteoporosis in at least one site. The mean SBAC-L1 was 192.3 (±52.4) HU; 163 patients (16.1%) were under the threshold of 145 HU. Older age (OR[CI95] = 1.1 [1.08-1.16]), lower BMD on the femoral neck and spine (OR[CI95] = 0.04[0.005-0.33] and OR[CI95] = 0.001[0.0001-0.008], respectively), and higher lean mass (OR[CI95] = 1.1 [1.03-1.13]) were significantly associated with an SBAC-L1 ≤ 145 HU in multivariate analysis. Approximately 16% of patients with severe obesity were under the SBAC-L1 threshold, while less than 1% were classified as osteoporotic on DXA.

11.
Prev Med Rep ; 29: 101968, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36161109

ABSTRACT

One of the biggest tasks for health professionals is to address the needs of persons with chronic illnesses like type 1 diabetes (T1D) and to support the acquisition of all necessary self-management behaviors. Functional insulin therapy (FIT) enables patients to adapt insulin doses according to everyday situations and reduces the risk of complications of diabetes. The aim was to describe the co-development, with patient as partners, of an eHealth tool for the acquisition of skills in FIT, to evaluate the user's acceptability and learning effectiveness on a sample of T1D patients followed in the University Hospital of Nancy. Subjects were invited to participate between July and August 2020. A total of 35 participants from different professional categories, median age of 41 years (IQR 27; 60) were included. In 22 subjects having access to all learning activities, there were positive relationships between the success score and the task (Spearman's rank correlation coefficient rs = 0.5), between the intent to use and following parameters: perceived utility (rs = 0.694), educational adequacy (rs = 0.786), tasks rs = (0.664), technology (rs = 0.520) and ease of use (rs = 0.659). This pilot study describes a user-centered approach to development of an eHealth tool for the acquisition of self-management skills in FIT. The online tool was well accepted and showed a positive impact on learning. The concept presented here will be useful to prompt future eHealth interventions in T1D or other chronic conditions aiming to increase patients' autonomy to prevent disease-related complications.

12.
Front Psychiatry ; 13: 960512, 2022.
Article in English | MEDLINE | ID: mdl-36159928

ABSTRACT

Background: Bipolar disorders (BD) is a common, chronic and disabling psychiatric condition. In addition to being characterized by significant clinical heterogeneity, notable disturbances of sleep and cognitive function are frequently observed in all phases of the disease. Currently, there is no readily available biomarker in current clinical practice to help diagnose or predict the disease course. Thus, identification of biomarkers in BD is today a major challenge. In this context, the study of electrophysiological biomarkers based on electroretinogram (ERG) measurements in BD seems highly promising. The BiMAR study aims to compare electrophysiological data measured with ERG between a group of euthymic patients with BD and a group of healthy control subjects. Secondarily, we will also describe the existing potential relationship between clinical, sleep and neuropsychological phenotypes of patients and electrophysiological data. Methods: The BiMAR study is a comparative and monocentric study carried out at the Expert Center for BD in Nancy, France. In total, 70 euthymic adult patients with BD and 70 healthy control subjects will be recruited. Electrophysiological recordings with ERG and electroencephalogram (EEG) will be performed with a virtual reality headset after a standardized clinical evaluation to all participants. Then, an actigraphic monitoring of 21 consecutive days will be carried out. At the end of this period a neuropsychological evaluation will be performed during a second visit. The primary outcome will be electrophysiological measurements with ERG flash and pattern. Secondary outcomes will be EEG data, sleep settings, clinical and neuropsychological assessments. For patients only, a complementary ancillary study, carried out at the University Hospital of Nancy, will be proposed to assess the retinal structure and microvascularization using Optical Coherence Tomography. Recruitment started in January 2022 and will continue until the end of July 2023. Discussion: The BiMAR study will contribute to identifying candidate ERG electrophysiological markers for helping the diagnosis of BD and identify subgroups of patients with different clinical profiles. Eventually, this would allow earlier diagnosis and personalized therapeutic interventions. Clinical trial registration: The study is registered at Clinicaltrials.gov, NCT05161546, on 17 December 2021 (https://clinicaltrials.gov/ct2/show/NCT05161546).

13.
J Clin Med ; 11(13)2022 Jun 24.
Article in English | MEDLINE | ID: mdl-35806932

ABSTRACT

Remote photoplethysmography imaging (rPPG) is a new solution proposed to measure vital signs, such as respiratory rate (RR) in teleconsultation, by using a webcam. The results, presented here, aim at evaluating the accuracy of such remote measurement methods, compared with existing measurement methods, in a real-life clinical setting. For each patient, measurement of RR, using the standard system (control), has been carried out concomitantly with the experimental system. A 60-s time frame was used for the measurements made by our rPPG system. Age, gender, BMI, and skin phototype were collected. We performed the intraclass correlation coefficient and Bland-Altman plot to analyze the accuracy and precision of the rPPG algorithm readings. Measurements of RR, using the two methods, have been realized on 963 patients. Comparison of the two techniques showed excellent agreement (96.0%), with most of the patients (n = 924-standard patients) being in the confidence interval of 95% in Bland-Altman plotting. There were no significant differences between standard patients and outlier patients for demographic and clinical characteristics. This study indicates a good agreement between the rPPG system and the control, thus allowing clinical use of this remote assessment of the respiratory rate.

14.
Sci Rep ; 12(1): 12593, 2022 07 22.
Article in English | MEDLINE | ID: mdl-35869273

ABSTRACT

The aim of this study was to evaluate the real intensity level of exercise in a sample of patients with chronic disease from obesity, rheumatology, hematology and other departments involved in a hospital-based program of adapted physical activity (APA). For this cross-sectional study, we studied seventy-five patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test before participating in a supervised APA practice using a telemetry wireless system to monitor heart rate (HR) during the first session. Based upon the results of the functional evaluation of exercise performance, we studied two groups of patients: (1) No limitation in exercise performance (maximal oxygen uptake greater than or equal to 80% of the theoretical reference) and (2) limited exercise performance (maximal oxygen uptake less than 80% of the theoretical value). Fifty-two patients (69.3%) were women, mean age was 42.6 (± 13.8), and mean BMI was 36.7 (± 10.6). Most patients had been referred for obesity (57.3%). We found 39 patients with normal exercise capacities and 36 patients with limited exercise performance. There were no significant differences in demographic and clinical characteristics between the two groups. For all populations, the mean and median real intensity levels of exercise in a sample of patients were moderate (55-70% HR max) and were the same for both groups. During the most intensive 15-min bout of the APA session, the HR for patients in both groups was greater than 70% of the actual maximum HR. This study observed a moderate level of APA exercise intensity in patients suffering from various chronic diseases. We found no significant difference in intensity level of exercise between patients' capacities, i.e., with and without limitation of their maximal performance.


Subject(s)
Exercise Tolerance , Oxygen Consumption , Adult , Chronic Disease , Cross-Sectional Studies , Exercise/physiology , Exercise Test , Exercise Tolerance/physiology , Female , Heart Rate/physiology , Humans , Male , Obesity , Oxygen , Oxygen Consumption/physiology
15.
J Appl Stat ; 49(6): 1519-1539, 2022.
Article in English | MEDLINE | ID: mdl-35707109

ABSTRACT

Online learning is a method for analyzing very large datasets ('big data') as well as data streams. In this article, we consider the case of constrained binary logistic regression and show the interest of using processes with an online standardization of the data, in particular to avoid numerical explosions or to allow the use of shrinkage methods. We prove the almost sure convergence of such a process and propose using a piecewise constant step-size such that the latter does not decrease too quickly and does not reduce the speed of convergence. We compare twenty-four stochastic approximation processes with raw or online standardized data on five real or simulated data sets. Results show that, unlike processes with raw data, processes with online standardized data can prevent numerical explosions and yield the best results.

16.
J Clin Med ; 11(9)2022 Apr 29.
Article in English | MEDLINE | ID: mdl-35566640

ABSTRACT

BACKGROUND: Refractory cardiac arrest management relies on extracorporeal cardiopulmonary resuscitation (ECPR), requiring the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Circulatory flow recovery can be associated with an ischemia-reperfusion injury, leading to vasoplegia and vasopressor requirement. The aim of this work was to evaluate the impact on hemodynamics of a methylene blue bolus infusion in a porcine model of ischemic refractory cardiac arrest. METHODS: Ischemic refractory cardiac arrest was induced in 20 pigs. After a low flow period of 30 min, VA-ECMO was initiated and the pigs were randomly assigned to the standard care group (norepinephrine + crystalloids) or methylene blue group (IV 2 mg·kg-1 bolus of methylene blue over 30 min + norepinephrine and crystalloids). Macrocirculatory parameters and lactate clearance were measured. Sublingual microcirculation was evaluated with sidestream dark field (SDF) imaging. The severity of the ischemic digestive lesions was assessed according to the histologic Chiu/Park scale. RESULTS: Eighteen pigs were included. The total crystalloid load (5000 (6000-8000) mL vs. 17,000 (10,000-19,000) mL, p = 0.007, methylene blue vs. standard care group) and catecholamine requirements (0.31 (0.14-0.44) µg·kg-1·min-1 vs. 2.32 (1.17-5.55) µg·kg-1·min-1, methylene blue vs. standard care group, p = 0.004) were significantly reduced in the methylene blue group. There were no significant between-group differences in lactate clearance, sublingual capillary microvascular parameters assessed by SDF or histologic Chiu/Park scale. CONCLUSIONS: In our refractory cardiac arrest porcine model treated with ECPR, methylene blue markedly reduced fluid loading and norepinephrine requirements in comparison to standard care during the first 6 h of VA-ECMO.

17.
Healthcare (Basel) ; 10(5)2022 Apr 19.
Article in English | MEDLINE | ID: mdl-35627895

ABSTRACT

Background: This study aimed to evaluate the efficacy of the Six-Minute Walk Test (6MWT) to determine the physical activity capacities of patients with chronic disease. Methods: For this cross-sectional study, we investigated 156 patients with chronic disease and no beta-blocker treatment. They systematically performed a maximal cardiopulmonary exercise test to determine their heart rate peak (HRPeak) and maximal oxygen uptake (V'O2max). We considered two groups of patients based upon the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max less than 80% of the theoretical value). All patients also received a 6MWT on the same day as the exercise test. Results: We found 68 (43.6%) patients with normal exercise capacities and 88 (56.4%) patients with limited exercise performance. In this sample, 6MWT mean distances were 510 (87) and 506 (86) m, respectively. There were no significant differences between the two groups for distance and end-test heart rate. The correlation between matrix V'O2max measured during the maximal incremental exercise test and the 6MWT distance displayed a positive slope (r = 0.549 CI95 [0.431−0.656]­p < 0.001). Conclusion: Our results showed a moderate relationship between 6MWT and physical activity capacity for patients with chronic disease.

18.
Healthcare (Basel) ; 10(5)2022 Apr 23.
Article in English | MEDLINE | ID: mdl-35627924

ABSTRACT

BACKGROUND: This study aimed to assess the prevalence of alexithymia in a sample of university students and to determine its association with specific sports practice characteristics (competition and training). METHODS: In this cross-sectional study, anthropometric data and characteristics of sport practice were collected, as well as level of alexithymia (Toronto Alexithymia Scale, (TAS-20)). RESULTS: The study included 253 French university students who completed a questionnaire specifying their regular sports practice and level of alexithymia (TAS-20). We found 76 subjects (30%) who had proven alexithymia and 92 (36.4%) who were borderline alexithymic. A significant positive relationship between alexithymia and the weekly amount of training practice was observed. It should be noted that students who engage in more than 5 h of physical activity are more prone to be borderline or alexithymic (respectively, 19.6 and 19.7% versus 7.1% for non-alexithymics; p = 0.03). CONCLUSION: With a 30% frequency, alexithymia is more prevalent in this context than in the general population. Furthermore, alexithymia and borderline alexithymia are most favorably associated with higher physical activity (over 5 h per week).

19.
Front Sports Act Living ; 4: 839509, 2022.
Article in English | MEDLINE | ID: mdl-35368419

ABSTRACT

Objective: This study aimed to evaluate the efficacy of the 1-minute Sit to Stand test (1MSTS) to determine physical activity capacities for patients with chronic disease. Methods: For this cross-sectional study, we studied fifty patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test to determine maximal oxygen uptake (V'O2max). We considered two groups of patients based on the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max <80% of the theoretical value). All patients also received an 1MSTS on the same day. Results: We found 22 (44.0%) patients with normal exercise capacity and 28 (56.0%) patients with limited exercise performance. In this sample, mean 1MSTS repetitions were 27.1 (7.1) and 25.2 (8.7), respectively. There were no significant differences between the two groups for repetition and Borg Scale end test. The correlation between V'O2max measured during the exercise test and 1MSTS repetitions displayed a positive slope [r = 0.401 (95% CI 0.114-625)]. Conclusion: This study demonstrated a moderate relationship between 1MSTS and V'O2max for patients with chronic disease. 1MSTS did not permit the precise determination of physical activity capacities in this sample.

20.
Healthcare (Basel) ; 10(3)2022 Feb 25.
Article in English | MEDLINE | ID: mdl-35326910

ABSTRACT

BACKGROUND: This was a multicenter, cross-sectional study which aimed to investigate the relationship between the characteristics of sport practice (weekly training duration, level of practice) and alexithymia in adults who were officially licensed at a sports club. METHODS: From a sample of sports club licensed adults, 188 participants were included. The participants completed computerized questionnaires on anthropometric data and characteristics of sport practice (level and weekly time spent on sport practice) as well as alexithymia (TAS 20), depression (BDI-13) and anxiety traits (STAI-Y form B). RESULTS: In this sample, 91 (48.4%) and 97 (51.6%) athletes engaged in recreational and competitive sport practice, respectively. We observed a prevalence of 31.9% for alexithymia. Moreover, alexithymics were more involved in competitive than recreational practice (40.2% versus 23.1%, respectively; p = 0.019) and they were less anxious (63.9% versus 80.2%, respectively; p = 0.010). Finally, alexithymia was significantly more pronounced than non-alexithymia among sports competition practitioners (OR: 3.57 (95 CI [1.26-10.08]; p = 0.016) and we observed less alexithymia in team sports practice than confrontation sports (OR: 0.20 (95 CI [0.05-0.78]; p = 0.020). CONCLUSIONS: Alexithymic athletes were more involved in competition than recreational sports compared to non-alexithymic subjects, whilst there were more alexithymic athletes in confrontation sports than in team sports.

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