27 research outputs found

    No Benefit of Concomitant Immunomodulator Therapy on Efficacy of Biologics That Are Not Tumor Necrosis Factor Antagonists in Patients With Inflammatory Bowel Diseases: A Meta-analysis

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    International audienceBACKGROUND & AIMS: There is debate over whether patients with inflammatory bowel diseases (IBD) treated with biologics that are not tumor necrosis factor antagonists (such as vedolizumab or ustekinumab) should receive concomitant treatment with immunomodulators. We conducted a meta-analysis to compare the efficacy and safety of concomitant immunomodulator therapy vs vedolizumab or ustekinumab monotherapy. METHODS: In a systematic search of publications, through July 31, 2019, we identified 33 studies (6 randomized controlled trials and 27 cohort studies) of patients with IBD treated with vedolizumab or ustekinumab. The primary outcome was clinical benefit, including clinical remission, clinical response, or physician global assessment in patients who did vs did not receive combination therapy with an immunomodulator. Secondary outcomes were endoscopic improvement and safety. We performed random-effects meta-analysis and estimated odds ratio (OR) and 95% CIs. RESULTS: Overall, combination therapy was not associated with better clinical outcomes in patients receiving vedolizumab (16 studies: OR, 0.84; 95% CI, 0.68-1.05; I2 = 13.9%; Q test P = .17) or ustekinumab (15 studies: OR, 1.1; 95% CI, 0.87-1.38; I2 = 11%; Q test P = .28). Results were consistent in subgroup analyses, with no difference in clinical remission or response in induction vs maintenance studies or in patients with Crohn's disease vs ulcerative colitis in studies of vedolizumab. Combination therapy was not associated with better endoscopic outcomes in patients receiving vedolizumab (3 studies: OR, 1.13; 95% CI, 0.48-2.68; I2 = 0; Q test P = .96) or ustekinumab (2 studies: OR, 0.58; 95% CI, 0.21-1.16; I2 = 47%; Q test P = .17). Combination therapy was not associated with an increase in adverse events during vedolizumab therapy (4 studies: OR, 1.17; 95% CI, 0.75-1.84; I2 = 0; Q test P = .110). CONCLUSIONS: In a meta-analysis of data from studies of patients with IBD, we found that combining vedolizumab or ustekinumab with an immunomodulator is no more effective than monotherapy in induction or maintenance of remission

    Can the European abalone Haliotis tuberculata survive on an invasive algae? A comparison of the nutritional value of the introduced Grateloupia turuturu and the native Palmaria palmata, for the commercial European abalone industry

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    ©. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/ This document is the Published/Accepted/Submitted Manuscript version of a Published Work that appeared in final form in [Journal of Applied Phycology]. To access the final edited and published work see[10.1007/s10811-015-0741-z

    Seasonal antibacterial activity of two red seaweeds, Palmaria palmata and Grateloupia turuturu, on European abalone pathogen Vibrio harveyi

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    International audienceVibrio harveyi is the main pathogen of the European abalone Haliotis tuberculata, and recently caused important mortalities at the production sites of this marine gastropod in France. In the present work, the monthly antibacterial activity of two red seaweed species from the French Atlantic coast, the native Palmaria palmata and the introduced Grateloupia turuturu, were investigated against the abalone pathogen Vibrio harveyi strain ORM4. Water-soluble extracts were screened using the microplate method. Grateloupia turuturu showed an antibacterial activity with a maximal growth inhibition in spring of around 16%. In contrast, Palmaria palmata was inactive, as further growth of the bacteria was observed. Preliminary one-dimensional proton nuclear magnetic-resonance (H-1 NMR) profiles identified the differences between the two water-soluble extracts

    Seasonal variation in the antivibrio activity of two organic extracts from two red seaweed: Palmaria palmata and the introduced Grateloupia turuturu against the abalone pathogen Vibrio harveyi

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    The wide polarity range and highly polar compounds of two selected red seaweed, Grateloupia turuturu and Palmaria palmata were extracted using two different types of solvent, dichloromethane/methanol and methanol/water. Monthly in vitro antibacterial activities were studied using the microplate method against the marine bacteria Vibrio harveyi strain ORM4, known to infect abalone. Inhibition, slowdown and delay of Vibrio harveyi growth were investigated. Polar compounds of seaweed showed an activity against the abalone pathogen. The best activity was recorded from P. palmata collected in spring, with an inhibition of 7.9% of the bacterial growth. Preliminary 1H NMR profiles identified the differences between the extracts

    Preliminary tolerance analysis of adjuvant chemotherapy in older patients after resection of stage III colon cancer from the PRODIGE 34-FFCD randomized trial

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    Background: Colon adenocarcinoma mainly occurs in older patients. Oxaliplatin-based adjuvant chemotherapy improved disease-free survival after stage III colon cancer resection, but this improvement was not demonstrated in older patients. Methods: The purpose of ADAGE-PRODIGE 34, randomized open phase III trial is to compare in patients over 70 years oxaliplatin plus fluoropyrimidine with fluoropyrimidine alone in fit patients (Group 1) and fluoropyrimidine with observation in frail patients (Group 2) after resection of stage III colon adenocarcinoma. We report a preliminary tolerance analysis on 50% of the first patients enrolled. Results: The analysis was conducted on 491 patients (378 in Group 1 and 113 in Group 2). Patients in Group 2 were older and showed more frailty criteria than those in Group 1. Cumulative grade 3-5 toxicities were more frequent in patients treated with oxaliplatin in Group 1 or with fluoropyrimidine in Group 2 than in patients treated with fluoropyrimidine in Group 1. At least one course was deferred in more than half of the patients in all groups. Early treatment cessation was more frequent in Group 2. Conclusion: No safety concerns were raised for the continuation of accrual. The frailty criteria distribution suggests that the investigator's evaluation for group allocation was accurate

    Impaired microvascular function in patients with sickle cell anemia and leg ulcers improved with healing

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    International audienceSummary Leg Ulcer (LU) pathophysiology is still not well understood in sickle cell anaemia (SCA). We hypothesised that SCA patients with LU would be characterised by lower microvascular reactivity. The aim of the present study was to compare the microcirculatory function (transcutaneous oxygen pressure (TcPO 2 ) on the foot and laser Doppler flowmetry on the arm) and several blood biological parameters between nine SCA patients with active LU (LU+) and 56 SCA patients with no positive history of LU (LU−). We also tested the effects of plasma from LU+ and LU− patients on endothelial cell activation. We observed a reduction of the TcPO 2 in LU+ compared to LU− patients. In addition, LU+ patients exhibited lower cutaneous microvascular vasodilatory capacity in response to acetylcholine, current and local heating compared to LU− patients. Inflammation and endothelial cell activation in response to plasma did not differ between the two groups. Among the nine patients from the LU+ group, eight were followed and six achieved healing in 4.4 ± 2.5 months. Among thus achieving healing, microvascular vasodilatory capacity in response to acetylcholine, current and local heating and TcPO 2 improved after healing. In conclusion, microcirculatory function is impaired in patients with LU, and improves with healing
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