Laboratoire Dr Renaud

To examine sex- and age-related differences in patterns of post-concussive symptoms (PCS), across cognitive, somatic, emotional, and behavioral domains, and their recovery within the first 6 months after mild traumatic brain injury (mTBI), and their relation to participation. Data were collected from patients visiting the emergency departments of 14 hospitals in the Netherlands. Two hundred 8 to 17-year-old children with mTBI and their caregivers, and 186 adults with mTBI. Data were collected in 2 prospective cohort studies, with assessments at 2 weeks and 6 months post-injury. Data were analyzed using Multivariate Latent Class Growth Analysis to detect latent PCS patterns (classes), multivariate logistic regressions to assess age and sex differences between classes, and Kruskal-Wallis tests to investigate class differences in participation. PCS were assessed with the Health and Behavior Inventory (children) and the Rivermead Post-Concussion Symptoms Questionnaire (adults). Participation (being involved in daily life situations) was assessed with the Child and Adolescent Scale of Participation (children) and the Utrecht Scale for Evaluation and Rehabilitation-Participation (adults). Three distinct classes with unique PCS recovery trajectories were found across samples (children/caregiver, adults). In child-reported PCS, sex differences were found, driven by higher levels of somatic and emotional PCS in females. No sex differences were found in caregiver reports or in adult reports. Age differences were found in the caregiver report for the child sample, with higher ages found in the class showing decreasing somatic symptoms over time, and in the adult sample, where younger individuals were more often in the class with recovered PCS. Classes differed in their levels of participation in all samples. Findings highlight the heterogeneity of PCS across the lifespan as well as the variation of discrepancies in sex- and age-related findings. Taking age and sex differences into account increases our understanding of recovery patterns after mTBI and allow identification of at-risk individuals and better-tailored interventions.

Scalp seborrheic dermatitis (SD) can cause physical discomfort and social embarrassment in affected individuals. Mild-to-moderate scalp SD can be managed using topical products with antifungal, antiinflammatory, and keratolytic properties. A two-phase, randomized, controlled study was conducted to evaluate the clinical efficacy of a newly formulated anti-SD shampoo containing two patented antifungal actives and to investigate the associated changes in the scalp microbiota. The intervention involved a 2-week intensive phase for the 42 subjects included in the study, consisting of the application of the anti-SD shampoo three times a week; a randomized [1:1], controlled, parallel-group 8-week maintenance phase consisting of the test group applying the study shampoo once a week alternately with a neutral shampoo twice a week; and the control group applying the neutral shampoo alone three times a week. Following the intensive phase, the scalp condition improved substantially, as evidenced by a significant decrease in the severity of dandruff, erythema, and pruritus, associated with an improvement of SD dysbiosis. These improvements were more sustained in the test group than in the control group during the maintenance phase. The rediversification of the scalp microbiota involved a significant increase in fungal and bacterial richness along with a decrease in the level of SD-predominant Malassezia fungi and Staphylococcus bacteria and an increase in the level of low-abundant fungi genera belonging to the Ascomycota phylum. The synergistic effects of antimycotic and antiinflammatory agents in the study shampoo likely contributed to rebalancing the fungal and bacterial ecosystem, thus improving scalp symptoms. NCT06578962 (retrospectively registered on 28 August 2024).

The species of Siderus Kaye present in French Guiana are listed and detailed with notes on male territorial behavior and the plants at which adults feed. In total, seven species were recorded: Siderus leucophaeus (Hübner); Siderus parvinotus Kaye (first record from French Guiana); Siderus athymbra (Hewitson); Siderus diringeri Faynel, Robbins & Fåhraeus sp. nov.; Siderus bisignatus Faynel, Ramírez & Robbins sp. nov.; Siderus castelain Faynel, Fåhraeus & Robbins sp. nov. and Siderus toussaint Faynel, Robbins & Fåhraeus sp. nov. A preliminary delimitation of the genus Siderus is proposed. Description, distribution, detailed illustrations of adults and male genitalia (and some female) are provided for each new species.

Alopecia areata (AA) can negatively affect quality of life (QoL) and is associated with increased prevalence of anxiety and depression (vs people without AA). This study compared physician-assessed and patient self-rated severity of AA in a European sample and described the patient-reported burden of AA stratified by physician-assessed severity. Real-world data were collected from the Adelphi Real World AA Disease Specific Programme™, a retrospective point-in-time cross-sectional survey of dermatologists and their adult patients with AA in five European countries (France, Germany, Italy, Spain, UK). Physicians provided clinical data and an AA severity assessment, according to their own definition of 'mild', 'moderate' and 'severe'. Patients were invited to provide their perception of AA severity and completed patient-reported outcome (PRO) questionnaires, including Skindex-16 for AA (Skindex-16 AA), EuroQol-5-dimension questionnaire 5-level (EQ-5D-5L), Hospital Anxiety and Depression Scale and the Work Productivity and Activity Impairment Questionnaire. Data for 2083 patients were collected by 239 physicians; 561 of these patients completed PRO questionnaires. In 78.5% of cases with available data (N = 549), there was alignment between patient and physician-rated AA severity (severity was rated higher by physicians in 15.7% of cases, by patients in 5.8% of cases). Data from all PRO instruments showed an increase in patient-reported burden and work and activity impairment with increasing physician-rated AA severity. For the Skindex-16 AA, the Emotions scale had the worst scores; anxiety/depression was the EQ-5D-5L dimension with the highest percentages of patients reporting any perceived problem. These data highlight the significant impact that AA can have beyond hair loss, especially for patients with severe AA. There was substantial physician-patient alignment on severity assessment. Higher physician-rated AA severity was associated with higher levels of patient-reported disease burden, including anxiety and depression, and work and activity impairment. These data may help inform appropriate treatment strategies.

À la fin d’une carrière bien remplie d’enseignant universitaire et de chercheur, à Paris, Abidjan, Niamey et Aix-en-Provence, Jean-Louis Triaud livre une somme sur l’histoire de la vie islamique en Côte d’Ivoire depuis le début du xxe siècle jusqu’en 1960. L’auteur est connu, entre autres, pour son histoire de La légende noire de la Sanussiyya (1995) particulièrement dans ses développements au Tchad. Pourquoi donc la Côte d’Ivoire ? Il donne lui-même la réponse (p. 12) en rappelant qu’il a c...

Introduction: Ultra-fast cooling with total liquid ventilation (TLV) is potently protective in animal models of cardiac arrest. Hypothesis: Here, we hypothesized that this protection involves a mitigation of the acute phase of the inflammatory syndrome after cardiac arrest. Methods: Rabbits were anesthetized and submitted to 10 min of ventricular fibrillation. After resuscitation, animals underwent normothermic follow-up (Control, n=6) or ultra-fast cooling by TLV started after resuscitation (TLV, n=6). TLV was used for induction of cooling during 20 min and hypothermia was further maintained during 3 h using external techniques before rewarming. A third group was submitted to a Sham procedure (n=5). Survival and neurological dysfunction were assessed during 3 days. Results: TLV improved the clinical neurological recovery as compared to Control group after cardiac arrest. It was corroborated by histological examination showing an attenuation of neuronal degeneration in parasagittal cortex and hippocampus in TLV vs Control groups. After resuscitation, TLV delayed the elevation of interleukin-6 blood levels as compared to Control after cardiac arrest (e.g., 298±63 vs 991±471 pg/ml at 180 min after cardiac arrest in TLV vs Control, respectively). Blood cytometry analyses showed a massive recruitment of neutrophils and leukocytes (including T4, T8 and B-lymphocytes) in both groups. The early lymphocytosis was attenuated in TLV vs Control groups, despite not achieving statistical significance. Blood levels of high-mobility group box 1 increased rapidly and similarly in both groups after cardiac arrest. This suggests that TLV does not mitigate the early release of danger-associated molecular patterns after resuscitation, which is closely related to the immediate cell death after resuscitation. Altogether, these results show an attenuation of the early inflammatory response during hypothermia, suggesting a role of early but not delayed inflammation in the mechanism of ultra-fast cooling after cardiac arrest. Conclusion: Beneficial effect of hypothermic TLV could be explained by a delay in immune peripheral cells activation and cytokine release, rather than sustained inhibition of inflammation after cardiac arrest.

Background and Objectives: In-hospital cardiac arrest can be challenging. The frequency of events outside of critical care units is typically low which makes it a stressful event for staff. According to the HEROIC study, there were 209,000 in-hospital cardiac arrests in the United States in 2016. Only 24.9% survived. Get With the Guidelines-Resuscitation is a quality improvement tool for hospitals to measure and evaluate their in-house codes and resuscitation rates. It may be assumed that survival rates are better at larger hospitals. The objective of this study was to examine the association between in-hospital cardiac arrest rates based on the bed size of a hospital. Methods: By using number of beds as a comparison and data from Get With the Guidelines-Resuscitation we sampled 46 hospitals in the eleven-state AHA Midwest Affiliate, (IL, IN, IA, KS, MI, MN, MO, NE, ND, SD, WI), comparing survival to discharge from cardiac arrest, with and without shockable rhythms from January 1, 2013-December 31, 2016. All patients are included in a risk adjusted formula that resides within Get With the Guidelines-Resuscitation. Results: In our comparison, we included hospitals with licensed and/or staffed beds of <100, 100-199, 200-299, 300-399 and 400 or more beds. Our data showed that higher sustained return of spontaneous circulation rates with survival to discharge are not dictated by the size of a hospital. In fact, in all 4 years shown, successful resuscitation rates were higher at hospitals with fewer beds verses larger facilities. Conclusions: Survival to discharge from in-hospital cardiac arrest is not dependent on hospital bed size. It is important that hospitals collect and analyze data regarding in-hospital cardiac arrests to improve survival rates beyond the 24.9% identified in the HEROIC study. A further examination looking at discharge destinations with CPC scores should be considered for a future study.

Background: The long-term follow-up of clinical outcomes in patients admitted with acute stroke can identify relevant clinical data in the prevention of stroke recurrence as well as measure the quality of life of such patients. Follow-up after discharge in hospitals without stroke clinics can be a challenge. Therefore we created in our hospital an outcomes measurement nuclei characterized as a data collection center, with the main objective of periodically measuring clinical outcomes and quality of life of patients after hospital discharge.This sector works together with the different clinical specialties in providing information with a focus on outcome indicators, using questionnaires to estimate the parameters of evaluation of health states.Our objective was to describe data obtained from this data collection center evaluating post-discharge quality of life of patients treated in our stroke center 30, 90, 180 days and 01 years after the diagnosis. Methods: The study was conducted from January 2012 to March 2016, at a tertiary, general, private hospital in São Paulo, Brazil. Phone calls using the EuroQol instrument (EQ-5D) to measure quality of life were performed. The modified Rankin scale and a structured questionnaire to identify stroke recurrence, readmissions and medication failures were also applied. Results: We conducted 2184 telephone calls and obtained 1727 (79%) successful contacts. The mean EQ-5D at 30 days was: 0.732 +/-0.558; at 90 days: 0.722 +/- 0.358; at 180 Days: 0.781 +/- 0.326; and at 12 months 0.766 +/-0.349. During the follow-up, 31 patients (2%) died. The main reasons for censuring patients were unsuccessful contact after 3 attempts (51%); outdated registration data (3%) and refusals (9%). Conclusion: In conclusion, monitoring of standardized clinical outcomes after stroke is possible even in private non academic hospitals, allowing the acquisition of quality of care indicators and patient centered outcomes.

Follicular hyperkeratosis along with hyperplasia of the follicular and interfollicular epithelia are major histopathological characteristics of hidradenitis suppurativa (HS). The presence of an occasional thickening of lesional skin in some folliculitis decalvans (FD) patients and histological similarities between FD and HS led us to look for epidermal hyperplasia and follicular hyperkeratosis in FD patients. We performed a retrospective histological analysis of 26 patients with FD. We sought to find out whether the presence of hyperplasia of the interfollicular epidermis and of the follicular epithelia could be verified in FD, with reference to the work of von Laffert et al. concerning HS. The main quantitative and qualitative data were: follicular hyperkeratosis (77%), hyperplasia of the interfollicular epidermis (92%) with a psoriasiform aspect (88%), atrophy of the follicular epithelia (85%), plasma cells in infiltrate (92%) in large quantities (42%), follicular microcysts (60%), atrophy of the sebaceous glands (85%) and polytrichia (54%). Epidermal hyperplasia, sometimes psoriasiform and follicular microcysts, are significant histological signs of FD, which have been ignored until now although they seem very common.