Marseille Public University Hospital System

Adipose tissue is an abundant and clinically accessible source of stromal cells. Stromal vascular fraction (SVF) and nanofat have been widely investigated for their regenerative potential; however, commercial systems vary considerably in yield, viability, and regulatory oversight. Most devices report fresh results only, with limited validation following cryopreservation. Mesenchymal stromal cells derived from adipose tissue have also attracted attention due to their accessibility, immunomodulatory effects, and multipotent differentiation capacity. Uvence has developed a proprietary workflow for adipose tissue processing that integrates washing, cryopreservation, thawing, and emulsification within a Human Tissue Authority-regulated laboratory. The process includes Good Manufacturing Practices (GMP) Annex 1-aligned environmental monitoring and independent quality control (QC) testing. Critically, this workflow validates postthaw cell viability, addressing a gap in current SVF/nanofat approaches. Three cryopreserved donor samples demonstrated a mean postthaw viability of ∼91% (range 90.5-92%), consistently exceeding the International Federation for Adipose Therapeutics and Science (IFATS)/ International Society for Cell and Gene Therapy (ISCT) 70% threshold. Benchmarking against global systems showed Uvence postthaw viability to be equivalent to or higher than fresh outcomes reported for enzymatic platforms (Celution, 85-91%; InGeneron, 86%) and mechanical platforms (Lipocube, Tulip, ∼96%). Unlike competitor devices, Uvence has validated freeze-thaw performance, providing a stable and compliant platform. This study also presents in vitro culture and characterization of stromal cells expanded from Uvence nanofat-derived SVF samples, including flow cytometry, morphology, and trilineage differentiation. Flow cytometry confirmed high expression of CD73, CD90, and CD105, with minimal expression of CD34/CD45, consistent with the ISCT criteria. While these findings are limited to research characterization and do not constitute approval for therapeutic use, they demonstrate that the Uvence workflow delivers a quality-focused approach to adipose tissue processing.

SummaryBackgroundOral anticoagulant (OAC) therapy increases bleeding risk but its impact on trauma outcomes and the benefit of reversal remains uncertain. This study aimed to evaluate 1/the effect of preinjury OAC therapy on trauma mortality and 2/the protective role of OAC reversal and its associated thrombotic risk.MethodsWe conducted an observational study using a prospective multicenter trauma registry between January 2012 and December 2023. OAC-treated patients were matched with non-OAC-treated patients using a propensity score. Univariable and multivariable logistic regressions assessed associations between OAC therapy and day 1 and day 7 mortality. The effect of guideline-concordant OAC reversal was evaluated. Thrombotic complications were recorded.FindingsOf the 27,426 trauma patients, 3% were OAC-treated. They were older, had more comorbidities, and experienced higher mortality. After matching (n = 2196), OAC therapy remained independently associated with increased mortality (day 1: OR 2·21, 95% CI [1·41–3·43]; day 7: OR 2·06, [1·41–3·00]), with greater risk from vitamin K antagonists (VKA) than direct oral anticoagulants (DOAC). Guideline-concordant OAC reversal, achieved only in 21% of cases, independently reduced mortality at day 1 (OR 0·10, 95% CI [0·03–0·31], p < 0·01) and day 7 (OR 0·51, 95% CI [0·22–0·97], p < 0·01). No significant association was found between reversal and thrombotic complications.InterpretationPreinjury OAC therapy substantially increased trauma mortality, particularly with VKA. Guideline-concordant reversal was associated with reduced mortality in both VKA- and DOAC-treated patients without excess thrombotic risk but remains underused. These findings emphasise the urgent need for systematic implementation of reversal strategies in OAC-treated trauma patients.FundingThe Traumabase registry is funded by several Regional Health Agencies (Agences Régionales de Santé, ARS): ARS Île-de-France, ARS Occitanie, ARS Grand Est, 10.13039/501100014160ARS Hauts-de-France, and ARS Auvergne-Rhône-Alpes. The registry is also funded by the French Road Safety Observatory—Road Safety Delegation Service (Observatoire National Interministériel de la Sécurité Routière—Délégation à la Sécurité Routière).

The study aims to evaluate the long-term incidence of cardiovascular events (CVE) and compare the effectiveness of medical and surgical interventions using a combined cardiovascular endpoint in individuals diagnosed with primary aldosteronism (PA). The authors carried out a multicentric, retrospective study in Marseille on a total of 106 inpatients divided into two samples with biologically proven primary aldosteronism, of whom 55 underwent surgical treatment and 51 received medical therapy between January 2014 and December 2022. The mean age of the sample was 53 years. Over a 54-month follow-up period, five patients in the medical group (10.64%) and three in the surgical group (5.45%) experienced a CVE (p=0.46). Although the difference was not statistically significant, the surgical group had more cardiovascular morbidity at baseline. At the end of the follow-up, the surgical group demonstrated a significant reduction in blood pressure (BP) (mean 126/74mmHg) compared to the medical group (mean 136/81mmHg) (p=0.02), with a significantly lower number of antihypertensive medications (1.23±1.5vs. 2.83±1.8, p<0.01). Additionally, the surgical group had a significantly higher serum potassium level at the end of follow-up despite similar potassium supplementation. The long-term incidence of CVE in PA did not significantly differ between medical and surgical treatment. However, there appears to be a trend toward reduced CVE over the long term in surgically treated patients who had excess cardiovascular morbidity at baseline. In addition, surgical treatment significantly improved BP control, with patients requiring fewer and demonstrating better serum potassium regulation.

BackgroundMost data on atrial fibrillation (AF) ablation using the first available pentaspline pulsed field ablation (PFA) catheter (Farapulse, Boston Scientific Inc) come from retrospective center-level registries collected in highly experienced centers.ObjectiveThis study aimed to provide exhaustive and prospective patient-level data on this new ablation modality.MethodsFRANCE-PFA is a nationwide registry (NCT06497933) that included all patients undergoing a first AF ablation using the pentaspline PFA catheter since the introduction of this technology in France. All French centers using this technology participated. Procedural data were prospectively collected at a patient level.ResultsThis registry included 5223 patients from 33 centers between March 2021 and February 2024 (mean age 65 ± 11 years, 55.4% paroxysmal AF). The procedure duration was 54 ± 23 minutes. Acute pulmonary vein isolation was achieved in 5211 patients (99.8%). The total number of PFA applications was 50 ± 22 with >70 applications in 746 patients (14.3%). Pulmonary vein isolation only was performed in 64.7% of patients (82.7% of paroxysmal AF, 44.5% of persistent AF, and 26.6% of long-standing persistent AF). The most common location for additional PFA lesion sets was the left atrium posterior wall in 1335 patients (25.6%), left atrium roof in 999 patients (19.1%), and mitral isthmus in 514 patients (9.8%). Major complications occurred in 50 patients (0.96%), with no esophageal complication or symptomatic phrenic nerve palsy reported in past hospital discharge.ConclusionIn this prospective and nationwide registry, AF ablation using the pentaspline PFA catheter seemed to be safe and acutely efficient, despite considerable heterogeneity in the number of patients treated at each center.Trial RegistrationNCT06497933.

ABSTRACT EVIDENS was a prospective, non-interventional, longitudinal study conducted in non-small cell lung cancer (NSCLC) patients receiving nivolumab in France. It recruited adults with pathologically confirmed NSCLC who initiated nivolumab between October 2016 and November 2017; the final results are reported here. Primary outcomes included baseline characteristics and 36-month overall survival (OS). Secondary outcomes included progression free survival (PFS), objective response rate (ORR), safety and health-related quality of life (HRQoL; assessed regardless of nivolumab continuation or interruption). Overall, 1423 patients were included in the analysis population (median age 66 years; non-squamous histology 69.1%; stage IV disease 91.5%; brain metastases 19.9%). Almost all patients (99.7%) had received prior chemotherapy, and most patients received nivolumab as second-line (73.5%) or later (26.1%) therapy. The 36-month OS rate was 19.7% (95% confidence interval [CI] 17.5–22.0); OS was significantly shorter in patients with squamous versus non-squamous tumors (9.8 [95% CI 8.6–11.2] months vs 11.8 [95% CI 10.2–13.2] months; p = 0.005). The 36-month PFS rate was 8.8% (95% CI 7.3–10.4). The 12-month investigator-assessed best ORR in the overall population was 20.4%. Eastern Cooperative Oncology Group performance status, smoking status, tumor histology, disease stage and liver metastasis independently predicted survival. Grade 3 and 4 treatment-related adverse events were reported in 8.0% and 0.8% of patients, respectively; eight treatment-related deaths occurred (0.005%). HRQoL was maintained with slight improvement throughout the study, without statistical significance. These results confirm that the real-world effectiveness and safety of nivolumab in these patients is similar to that observed in clinical trials.

ABSTRACTAcute respiratory infections (ARI) are a health priority, especially in countries with limited resources. They are a major cause of morbidity and mortality, especially among children and the elderly. In Senegal, the endemic circulation of respiratory viruses other than influenza has been demonstrated. However, there is a paucity of data exploring the genetic diversity of these viruses based on whole‐genome sequencing. In this study, we present data on the genetic diversity of respiratory viruses in children under 15 years old in Senegal, including an overview of the different pathogens detected. Between November 2022 and November 2023, we collected nasopharyngeal swabs from children seen in curative consultations for symptoms of acute respiratory infections. Of the 156 children included, 73.7% tested positive for at least one pathogen. The most frequently detected virus was rhinovirus (50.0%), followed by influenza B (41.6%) and human parainfluenza virus type 3 (7.6%). Combinations of rhinovirus/influenza B, human parainfluenza virus type 2/human parainfluenza virus type 4, and rhinovirus/influenza B/adenovirus were the most frequently identified. A statistically significant association was detected between some of the viruses detected. A high genetic diversity of respiratory viruses circulating in children was revealed. The strains were phylogenetically close to various strains circulating worldwide, suggesting a global circulation of respiratory viruses. Our study provides the first complete genome sequences of human parainfluenza viruses type 2, 3, 4 and human bocavirus from Senegal and thus contributes to the enrichment of international databases on sequences from Senegal and underlines the importance of sequencing in the dynamics of pathogen circulation.

Background: The clinical course of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is variable. However, robust markers of poor outcome and/or relapse risk are still missing. Objective: To evaluate the frequency of cerebrospinal fluid-restricted oligoclonal bands (CSF-OCB) in a national cohort of adult MOGAD patients and to assess their prognostic value for the risk of relapse and severity. Methods: We included MOGAD adult patients fulfilling the MOGAD 2023 criteria who underwent CSF analysis at maximum 3 months from onset. Results: Data from 190 patients were collected. We found the presence of CSF-OCB in 32 patients (16.8%). Positive and negative CSF-OCB patients were similar for median age at onset, sex, clinical presentation, severity at onset, and residual disability. Relapses were more frequent in the CSF-OCB+ group (p = 0.049), particularly within the first year of follow-up (p = 0.007). Although CSF-OCB+ was more frequently associated with imaging features suggestive of multiple sclerosis (MS) (p = 0.014), 78% of these patients fulfilled the 2023 supportive features and 65% experienced lesion vanishing at follow-up magnetic resonance imaging (MRI). Conclusion: We found a higher risk of relapse in MOGAD with CSF-OCB particularly during the first year. Close attention is recommended regarding the risk of misdiagnosis with MS.