The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Loïc Guillevin - One of the best experts on this subject based on the ideXlab platform.
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eosinophilic granulomatosis with polyangiitis churg strauss
Seminars in Respiratory and Critical Care Medicine, 2018Co-Authors: Yann Nguyen, Loïc GuillevinAbstract:Eosinophilic granulomatosis with polyangiitis (EGPA), formerly called Churg-Strauss syndrome, is a systemic necrotizing vasculitis of small- and medium-size vessels, characterized by asthma and blood eosinophilia. EGPA typically occurs in patients with preexisting asthma, and involves the skin, lungs, and peripheral nerves. Poor-prognosis Factors (i.e., involvement(s) of the gastrointestinal tract, heart, and/or kidney) have been assessed with the Five-Factor Score (FFS). One-third of the patients have anti-myeloperoxidase antineutrophil cytoplasm antibodies, and their presence seems to differentiate between two phenotypes, with different clinical characteristics and prognoses. Overall survival has improved markedly since the use of glucocorticoids and immunosuppressants, but relapse rates remain high. All patients require glucocorticoids, and for those with severe/refractory disease and FFS-defined poor prognoses, immunosuppressants should be used (cyclophosphamide for induction and azathioprine for maintenance therapy). Recent advances in EGPA management, including several novel immunomodulatory drugs and targeted biotherapies, were or are being evaluated to improve EGPA patients' prognoses.
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:The 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomatosis (WG).We analyzed clinical, laboratory, and immunologic manifestations present at diagnosis of systemic necrotizing vasculitides for 1108 consecutive patients registered in the French Vasculitis Study Group database. All patients met the American College of Rheumatology and Chapel Hill nomenclature criteria. Univariable and multivariable analyses yielded the 2009 FFS for the 4 systemic necrotizing vasculitides.Overall mortality was 19.8% (219/1108); mortality for each of the SNV is listed in descending order: MPA (60/218, 27.5%), PAN (86/349, 24.6%), CSS (32/230, 13.9%), and WG (41/311, 13.2%) (p 65 years, cardiac symptoms, gastrointestinal involvement, and renal insufficiency (stabilized peak creatinine ≥150 μmol/L). All were disease-specific (p < 0.001); the presence of each was accorded +1 point. Ear, nose, and throat (ENT) symptoms, affecting patients with WG and CSS, were associated with a lower relative risk of death, and their absence was Scored +1 point (p < 0.001). Only renal insufficiency was retained (not proteinuria or microscopic hematuria) as impinging on outcome. According to the 2009 FFS, 5-year mortality rates for Scores of 0, 1, and ≥2 were 9%, 21% (p < 0.005), and 40% (p < 0.0001), respectively.The revised FFS for the 4 systemic necrotizing vasculitides now comprises 4 Factors associated with poorer prognosis and 1 with better outcome. The retained items demonstrate that visceral involvement weighs heavily on outcome. The better WG prognosis for patients with ENT manifestations, even for patients with other visceral involvement, compared with the prognosis for those without ENT manifestations, probably reflects WG phenotype heterogeneity.
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:AbstractThe 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomato
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microscopic polyangiitis clinical presentation
Autoimmunity Reviews, 2010Co-Authors: Peter M Villiger, Loïc GuillevinAbstract:Microscopic polyangiitis (MPA) is a member of the family of ANCA-associated vasculitides. Its characteristic histology shows a necrotizing small vessel vasculitis with little or absent immune deposits (pauci-immune vasculitis). In Western countries MPA shows a lower prevalence than Wegener's disease, it affects more men than women and commences at the age of > or = 50 years. The two organs most typically involved and often defining prognosis are the kidneys and the lungs. MPA may concomitantly or sequentially involve other organs such as the nervous system, the skin, the musculoskeletal system, but also the heart, the eye and the intestines. Treatment decisions should be based on severity and pattern of organ involvement and respect the five Factor Score (FFS). Life- or organ- threatening disease is treated with glucocorticoids and (pulse) cyclophosphamide. Plasmapheresis and i.v.immunoglobulins have been shown to be beneficial as additional measure in severe cases. If renal function is preserved, Methotrexate may be considered to induce remission, and if the FFS equals 0, remission may be induced with glucocorticoid monotherapy. Maintenance therapy is recommended with Azathioprin, mycophenolate mofetil may be used as a second line drug. Biologic agents such as monoclonal antibodies to tumor necrosis Factor a and B cell depleting rituximab have been shown to bear remission-inducing quality.
Philippe Le Toumelin - One of the best experts on this subject based on the ideXlab platform.
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:AbstractThe 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomato
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:The 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomatosis (WG).We analyzed clinical, laboratory, and immunologic manifestations present at diagnosis of systemic necrotizing vasculitides for 1108 consecutive patients registered in the French Vasculitis Study Group database. All patients met the American College of Rheumatology and Chapel Hill nomenclature criteria. Univariable and multivariable analyses yielded the 2009 FFS for the 4 systemic necrotizing vasculitides.Overall mortality was 19.8% (219/1108); mortality for each of the SNV is listed in descending order: MPA (60/218, 27.5%), PAN (86/349, 24.6%), CSS (32/230, 13.9%), and WG (41/311, 13.2%) (p 65 years, cardiac symptoms, gastrointestinal involvement, and renal insufficiency (stabilized peak creatinine ≥150 μmol/L). All were disease-specific (p < 0.001); the presence of each was accorded +1 point. Ear, nose, and throat (ENT) symptoms, affecting patients with WG and CSS, were associated with a lower relative risk of death, and their absence was Scored +1 point (p < 0.001). Only renal insufficiency was retained (not proteinuria or microscopic hematuria) as impinging on outcome. According to the 2009 FFS, 5-year mortality rates for Scores of 0, 1, and ≥2 were 9%, 21% (p < 0.005), and 40% (p < 0.0001), respectively.The revised FFS for the 4 systemic necrotizing vasculitides now comprises 4 Factors associated with poorer prognosis and 1 with better outcome. The retained items demonstrate that visceral involvement weighs heavily on outcome. The better WG prognosis for patients with ENT manifestations, even for patients with other visceral involvement, compared with the prognosis for those without ENT manifestations, probably reflects WG phenotype heterogeneity.
Tahoora Sheikhy Narany - One of the best experts on this subject based on the ideXlab platform.
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using multivariate statistical analysis geostatistical techniques and structural equation modeling to identify spatial variability of groundwater quality
Water Resources Management, 2015Co-Authors: Lazhar Belkhiri, Tahoora Sheikhy NaranyAbstract:Multivariate statistical analysis, geostatistical techniques and structural equation modeling were used to determine the main Factors and mechanisms controlling the spatial variation of groundwater quality in the Ain Azel plain, Algeria. Cluster analysis grouped the sampling wells into two statistically significant clusters based on similarities of groundwater quality characteristics. Principal component and Factor analyses (PCA/ FA) revealed that two Factors explained around 85 % of the total variance, which water-rock interaction and anthropogenic impact as the dominant Factors affecting the groundwater quality. The distribution of Factor Score one represents high loading for EC, Ca, Mg, Na, K, and SO4 in the western side and south eastern side of the plain, where water-rock interactions are dominate Factors influence groundwater quality. Spatial distribution map of Factor Score 2 indicate that NO3, NO2, NH4, and COD show high concentration in central and southern side of the plain, where anthropogenic impact reduce groundwater quality. Further, one-way analysis of variance (one-way ANOVA) showed that the mean differences between cluster one and two show significantly differences for some water quality parameters including EC, Ca, Mg, Na, K, Cl, and SO4. Structural equation modeling (SEM) confirmed the finding of multivariate analysis. This study provides a new technique of confirming exploratory data analysis using SEM in groundwater quality.
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using multivariate statistical analysis geostatistical techniques and structural equation modeling to identify spatial variability of groundwater quality
Water Resources Management, 2015Co-Authors: Lazhar Belkhiri, Tahoora Sheikhy NaranyAbstract:Multivariate statistical analysis, geostatistical techniques and structural equation modeling were used to determine the main Factors and mechanisms controlling the spatial variation of groundwater quality in the Ain Azel plain, Algeria. Cluster analysis grouped the sampling wells into two statistically significant clusters based on similarities of groundwater quality characteristics. Principal component and Factor analyses (PCA/ FA) revealed that two Factors explained around 85 % of the total variance, which water-rock interaction and anthropogenic impact as the dominant Factors affecting the groundwater quality. The distribution of Factor Score one represents high loading for EC, Ca, Mg, Na, K, and SO 4 in the western side and south eastern side of the plain, where water-rock interactions are dominate Factors influence groundwater quality. Spatial distribution map of Factor Score 2 indicate that NO 3 , NO 2 , NH 4 , and COD show high concentration in central and southern side of the plain, where anthropogenic impact reduce groundwater quality. Further, one-way analysis of variance (one-way ANOVA) showed that the mean differences between cluster one and two show significantly differences for some water quality parameters including EC, Ca, Mg, Na, K, Cl, and SO 4 . Structural equation modeling (SEM) confirmed the finding of multivariate analysis. This study provides a new technique of confirming exploratory data analysis using SEM in groundwater quality. Copyright Springer Science+Business Media Dordrecht 2015
Christian Pagnoux - One of the best experts on this subject based on the ideXlab platform.
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predictive Factors of severe infections in patients with systemic necrotizing vasculitides data from 733 patients enrolled in five randomized controlled trials of the french vasculitis study group
Rheumatology, 2020Co-Authors: Antoine Lafarge, Christian Pagnoux, Adrien Joseph, Xavier Puechal, Pascal Cohen, Maxime Samson, Mohamed Hamidou, Alexandre Karras, T Quemeneur, Camillo RibiAbstract:OBJECTIVES Infections remain a major cause of morbidity and mortality in systemic necrotizing vasculitides (SNV). We aimed to identify Factors predicting severe infections (SI) in SNV. METHODS Data from five randomized controlled trials (RCTs) enrolling 733 patients were pooled. The primary end point was the occurrence of SI, defined by the need of a hospitalization and/or intravenous anti-infectious treatment and/or leading to death. RESULTS After a median follow-up of 5.2 (interquartile range 3-9.7) years, 148 (20.2%) patients experienced 189 SI, and 98 (66.2%) presented their first SI within the first 2 years. Median interval from inclusion to SI was 14.9 (4.3-51.7) months. Age ≥65 years (hazard ratio (HR) 1.49 [1.07-2.07]; P=0.019), pulmonary involvement (HR 1.82 [1.26-2.62]; P=0.001) and Five Factor Score ≥1 (HR 1.21 [1.03-1.43]; P=0.019) were independent predictive Factors of SI. Regarding induction therapy, the occurrence of SI was associated with the combination of GCs and CYC (HR 1.51 [1.03-2.22]; P = 0.036), while patients receiving only GCs were less likely to present SI (HR 0.69 [0.44-1.07]; P = 0.096). Finally, occurrence of SI had a significant negative impact on survival (P<0.001). CONCLUSION SI in SNV are frequent and impact mortality. Age, pulmonary involvement and Five Factor Score are baseline independent predictors of SI. No therapeutic regimen was significantly associated with SI but patients receiving glucocorticoids and CYC as induction tended to have more SI.
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:AbstractThe 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomato
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the five Factor Score revisited assessment of prognoses of systemic necrotizing vasculitides based on the french vasculitis study group fvsg cohort
Medicine, 2011Co-Authors: Loïc Guillevin, Christian Pagnoux, Raphaele Seror, Alfred Mahr, Luc Mouthon, Philippe Le ToumelinAbstract:The 1996 Five-Factor Score (FFS) for systemic necrotizing vasculitides (polyarteritis nodosa [PAN], microscopic polyangiitis [MPA], and Churg-Strauss syndrome [CSS]) is used to evaluate prognosis at diagnosis. In the current study we revisited the FFS, this time including Wegener granulomatosis (WG).We analyzed clinical, laboratory, and immunologic manifestations present at diagnosis of systemic necrotizing vasculitides for 1108 consecutive patients registered in the French Vasculitis Study Group database. All patients met the American College of Rheumatology and Chapel Hill nomenclature criteria. Univariable and multivariable analyses yielded the 2009 FFS for the 4 systemic necrotizing vasculitides.Overall mortality was 19.8% (219/1108); mortality for each of the SNV is listed in descending order: MPA (60/218, 27.5%), PAN (86/349, 24.6%), CSS (32/230, 13.9%), and WG (41/311, 13.2%) (p 65 years, cardiac symptoms, gastrointestinal involvement, and renal insufficiency (stabilized peak creatinine ≥150 μmol/L). All were disease-specific (p < 0.001); the presence of each was accorded +1 point. Ear, nose, and throat (ENT) symptoms, affecting patients with WG and CSS, were associated with a lower relative risk of death, and their absence was Scored +1 point (p < 0.001). Only renal insufficiency was retained (not proteinuria or microscopic hematuria) as impinging on outcome. According to the 2009 FFS, 5-year mortality rates for Scores of 0, 1, and ≥2 were 9%, 21% (p < 0.005), and 40% (p < 0.0001), respectively.The revised FFS for the 4 systemic necrotizing vasculitides now comprises 4 Factors associated with poorer prognosis and 1 with better outcome. The retained items demonstrate that visceral involvement weighs heavily on outcome. The better WG prognosis for patients with ENT manifestations, even for patients with other visceral involvement, compared with the prognosis for those without ENT manifestations, probably reflects WG phenotype heterogeneity.
Lazhar Belkhiri - One of the best experts on this subject based on the ideXlab platform.
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using multivariate statistical analysis geostatistical techniques and structural equation modeling to identify spatial variability of groundwater quality
Water Resources Management, 2015Co-Authors: Lazhar Belkhiri, Tahoora Sheikhy NaranyAbstract:Multivariate statistical analysis, geostatistical techniques and structural equation modeling were used to determine the main Factors and mechanisms controlling the spatial variation of groundwater quality in the Ain Azel plain, Algeria. Cluster analysis grouped the sampling wells into two statistically significant clusters based on similarities of groundwater quality characteristics. Principal component and Factor analyses (PCA/ FA) revealed that two Factors explained around 85 % of the total variance, which water-rock interaction and anthropogenic impact as the dominant Factors affecting the groundwater quality. The distribution of Factor Score one represents high loading for EC, Ca, Mg, Na, K, and SO4 in the western side and south eastern side of the plain, where water-rock interactions are dominate Factors influence groundwater quality. Spatial distribution map of Factor Score 2 indicate that NO3, NO2, NH4, and COD show high concentration in central and southern side of the plain, where anthropogenic impact reduce groundwater quality. Further, one-way analysis of variance (one-way ANOVA) showed that the mean differences between cluster one and two show significantly differences for some water quality parameters including EC, Ca, Mg, Na, K, Cl, and SO4. Structural equation modeling (SEM) confirmed the finding of multivariate analysis. This study provides a new technique of confirming exploratory data analysis using SEM in groundwater quality.
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using multivariate statistical analysis geostatistical techniques and structural equation modeling to identify spatial variability of groundwater quality
Water Resources Management, 2015Co-Authors: Lazhar Belkhiri, Tahoora Sheikhy NaranyAbstract:Multivariate statistical analysis, geostatistical techniques and structural equation modeling were used to determine the main Factors and mechanisms controlling the spatial variation of groundwater quality in the Ain Azel plain, Algeria. Cluster analysis grouped the sampling wells into two statistically significant clusters based on similarities of groundwater quality characteristics. Principal component and Factor analyses (PCA/ FA) revealed that two Factors explained around 85 % of the total variance, which water-rock interaction and anthropogenic impact as the dominant Factors affecting the groundwater quality. The distribution of Factor Score one represents high loading for EC, Ca, Mg, Na, K, and SO 4 in the western side and south eastern side of the plain, where water-rock interactions are dominate Factors influence groundwater quality. Spatial distribution map of Factor Score 2 indicate that NO 3 , NO 2 , NH 4 , and COD show high concentration in central and southern side of the plain, where anthropogenic impact reduce groundwater quality. Further, one-way analysis of variance (one-way ANOVA) showed that the mean differences between cluster one and two show significantly differences for some water quality parameters including EC, Ca, Mg, Na, K, Cl, and SO 4 . Structural equation modeling (SEM) confirmed the finding of multivariate analysis. This study provides a new technique of confirming exploratory data analysis using SEM in groundwater quality. Copyright Springer Science+Business Media Dordrecht 2015
