The Bichat–Claude Bernard Hospital (French: Hôpital Bichat-Claude-Bernard [opital biʃa klod bɛʁnaʁ]) is located in the 18th arrondissement of Paris, France, and is operated by Assistance Publique – Hôpitaux de Paris (APHP). It was founded in 1881 as l'Hôpital Bichat (after Xavier Bichat), incorporating the units of nearby Hôpital Claude-Bernard upon the latter's demolition in 1970. The Bichat–Claude Bernard Hospital is also a teaching hospital of the University of Paris..
HIV post-exposure prophylaxis (PEP) uptake is low among men who have sex with men (MSM), even among those aware of it. We examined factors associated with not seeking PEP among MSM in the ANRS-PREVENIR cohort who were PrEP-naive at enrollment, aware of PEP, and reported a potential need for it in the previous 12 months. Among 3,193 participants, 632 (19.8
The beneficial effects of prophylactic noninvasive ventilation (NIV) after extubation in patients without hypercapnia are uncertain. Our objective was to assess the effects of prophylactic NIV on reintubation among patients without hypercapnia at the time of extubation. Post hoc analysis of two multicenter clinical trials including high-risk patients (i.e., patients older than 65 years or with underlying cardiac/respiratory disease). Our analysis focused on the 829 patients without hypercapnia (PaCO2 ≤ 45 mmHg), the day of extubation who received NIV alternating high-flow nasal cannula (HFNC) oxygen or HFNC alone after extubation. The primary outcome was the proportion of patients who required reintubation within seven days following extubation. We used G-computation to robustly estimate the marginal causal effect of treatment on the risk of reintubation. After extubation, 540 patients (65
Telomere-related gene (TRG) pathogenic variants are detected in ∼30% of familial pulmonary fibrosis (PF) cases. Danazol, a synthetic sex hormone with androgenic properties, has been found associated with telomere elongation and hematologic response in patients with short telomeres. The objective of the ANDROTELO multicenter, prospective, open-label single-arm phase II clinical trial ( NCT03710356 ) was to evaluate the efficacy and safety of danazol in carriers of TRG mutations with PF or bone-marrow failure (BMF).Included patients were carriers of a pathogenic or likely pathogenic TRG variant and presented a PF lung involving ≥10% parenchymal involvement on chest CT (PF group) and/or severe BMF (BMF group). Treatment was danazol 400 mg twice a day for 12 months. We included 25 patients with PF (16 males) and 5 with BMF (2 males). One PF patient withdrew consent. At inclusion, the median age in the PF group was 62.5 years, FVC 69% (interquartile range 40;120) and DLCO 44% (29;84). Ten of 24 PF patients (42%) completed the 12-month treatment. Causes of premature treatment discontinuation were side effects (n=9), death (n=3), lung transplantation (n=1), and disease progression (n=1). Fourteen PF patients were evaluated at month 12: 8 showed a relative decline of FVC of <5%. The median relative decrease in FVC and DLCO was −10% (interquartile range −14;−2) and −10.3% (−22.7;4.2). The 5 patients in the BMF group completed the 12-month treatment and exhibited at least partial response. Danazol was poorly tolerated in patients with TRG-related PF in this study, thus precluding efficacy assessment.
We introduce the European Union consensus report on the diagnosis and treatment of monoclonal gammopathy of renal significance (MGRS), a generic term to describe kidney disorders caused by a non-malignant monoclonal immunoglobulin clone. There are many subtypes of MGRS, with AL-amyloidosis being most prevalent. The consensus report aims at providing guidance to clinicians, pathologists and laboratory specialists who take care of patients with a (suspected) diagnosis of MGRS. This executive summary provides a condensed overview of the most important aspects of the diagnosis and management of patients with MGRS. Consultation of expert centers is strongly advised. Although most patients will benefit from hematological, clone-directed therapy, treatment decisions must be individualized, in view of the heterogeneity of patients between and within the MGRS subtypes. The final chapter discusses kidney transplantation in patients with MGRS. The working group acknowledges that most advice is based on low-quality evidence. The full report provides the rationale and a detailed discussion of the available literature. This executive summary is an introduction, and not a substitute for the full consensus report.
