Paris Descartes University Research Articles

"Transperineal Prostate Biopsies Under Local Anesthesia: Initial Experience"

Julien Anract1,2*, David Azoulai1, Quentin Manach3, Sabine Roux1, Michael Peyromaure1,2 and Nicolas Barry Delongchamps1,2 Author Affiliations 1Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France 2Inserm Unit U1151, Paris Descartes University, Paris, France 3Department of Urology, Saint Joseph Hospital, Paris, France Received: July 28, 2021 | Published: August 09, 2021 Corresponding author: Julien Anract, Department of Urology, Cochin Hospital, 123 Boulevard de Port Royal, 75014 Paris, France DOI: 10.26717/BJSTR.2021.37.006077

Patients’ perception of the open-space operating hall for cataract surgery

To assess the perception of patients undergoing cataract surgery under topical anesthesia in an open-space operating hall. The study was set in the department of ophthalmology, Cochin Paris Descartes University Hospital, in a newly built open-space operating hall dedicated to ophthalmic surgery. It was a prospective study of consecutive patients undergoing cataract surgery by 11 surgeons. Our population study comprised 250 patients operated in an open-space operating hall with 3 surgical areas. Only first-eye standard cataract surgeries performed under topical anesthesia were included. Responses to a face-to-face questionnaire administered by a single interviewer to patients before their discharge on the day of their surgery were analyzed. Fifty-two patients (21%) knew beforehand that their procedure would take place in an open-space operating hall, 118 (47%) realized that they were in such an environment on the occasion of their surgery and 80 (32%) did not notice. Conversations and noises unrelated to their own surgeries were overheard respectively by 15 (6%) and 37 (15%) patients. Of the 250 patients, 237 (95%) did not report any discomfort associated with the fact that their procedure had been performed in an open-space operating hall. Cataract surgery performed in an open-space setting did not seem to affect the patients' comfort during the procedure.

Personality traits are associated with cognitive empathy in medical students but not with its evolution and interventions to improve it

ObjectiveCognitive empathy might decrease during medical school. Factors associated with its evolution remain poorly understood, as well as whether such factors could moderate the effect of an intervention to preserve cognitive empathy. The aim was to explore the associations between personality traits and both cognitive empathy at baseline and its changes at follow-up. The possible effect of an intervention depended upon personality traits was also examined. MethodsThe cohort consisted of fourth year medical students and the associations between personality traits, using the Short Big Five Inventory, and cognitive empathy changes at 3-month, using the Jefferson Scale of Empathy-Student version (JSE-S), were examined. A randomization in two groups (Balint groups versus no intervention) allowed examining whether the effect of the intervention depended upon personality traits. Linear regressions were adjusted for gender, anticipated specialty choice, parental education, living status, financial insecurity, randomization group and baseline JSE-S. ResultsThe cohort included 311 participants from October 2015 to December 2016 at Paris Diderot and Paris Descartes University. At follow-up, there was a JSE-S total score increase of 1.22(SD:9.10) in the intervention group, compared to a decrease of 1.64(SD:10.74) in the other group. Baseline JSE-S was positively associated with Extraversion and Conscientiousness and negatively with Neuroticism. In contrast, we found no associations between baseline personality traits and JSE-S change. There were no interactions between personality traits and randomization group. ConclusionAlthough personality might be linked with cognitive empathy, medical students may benefit from strategies designed for improving cognitive empathy regardless of their personality.

3D Vector Reconstruction of the Cerebellum from Anatomical Sections of Korean Visible Human at the Clinical and Digital Anatomy Laboratory of Paris Descartes University

3D Vector Reconstruction of the Cerebellum from Anatomical Sections of Korean Visible Human at the Clinical and Digital Anatomy Laboratory of Paris Descartes University

3D Vector Reconstruction of the Brain from Anatomical Sections of Korean Visible Human at the Laboratory of Clinical and Digital Anatomy of Paris Descartes University

3D Vector Reconstruction of the Brain from Anatomical Sections of Korean Visible Human at the Laboratory of Clinical and Digital Anatomy of Paris Descartes University

3D Vector Reconstruction of the Atlas from Anatomical Sections of Korean Visible Human at the Laboratory of Clinical and Digital Anatomy of Paris Descartes University

Aim: Carry out a 3D vector reconstruction of the atlas from the anatomical sections of the Visible Human for educational purposes. Material and methods: The anatomical subject was a 33-year-old Korean man who died of leukemia. It measured 164 cm and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8,100 cuts were obtained. Only the sections numbered 780 to 860 were used for our study. A segmentation by manual contouring of the different parts of the atlas was done using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. Results: Our 3D vector model of the atlas is easy to manipulate using the Acrobat 3DPDF interface. The atlas accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. Conclusion: This original work constitutes a remarkable educational tool for the anatomical study of the atlas and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.

Bisphenol Exposure and Type 2 Diabetes: New Evidence for a Potential Risk Factor

Bisphenol Exposure and Type 2 Diabetes: New Evidence for a Potential Risk Factor

Entretien avec Catherine Chabert : méthode transmission et formation. Plaidoyer pour une approche théorico-clinique

AimBased on an interview with Catherine Chabert, psychoanalyst and professor emerita of clinical psychology at Paris Descartes University, the aim is to explore the stakes involved in transmission both in universities and in schools of psychoanalysis. MethodInterview with Catherine Chabert. The questions concern her personal training; then the method accompanying teaching, research, and training in psychology; and finally the place of psychoanalysis and metapsychology in transmission. ResultsCatherine Chabert insists on the importance of reading the texts in depth, a method she was taught in her studies in philosophy and then applied to Freud's texts, as a training tool. She also discusses the importance, for students, of exploring psychic functioning from a clinical psychological perspective based on a particular method, such as metapsychology or projective tests according to the approach of the Paris school. DiscussionC. Chabert was trained in research by both D. Widlöcher and D. Anzieu, and completed a psychology thesis and then a doctorate under their direction. Clinical activity is also inseparable from transmission and training in the back-and-forth between practice and theory, in this case metapsychology. But psychoanalysis also has an important place in training and transmission. Even if psychoanalysis is not meant to be taught in a university setting, to take into account the transferential effects in training and in the will and desire to learn. ConclusionWhile psychoanalysis is currently under attack, the fight to keep it alive and to allow it to enrich the teaching of clinical psychology must continue.

3D Vector Reconstruction of the Typical Cervical Vertebra from Anatomical Sections of Korean Visible Human at the Laboratory of Clinical and Digital Anatomy of Paris Descartes University

Aim: To carry out a 3D vector reconstruction of the typical cervical vertebra from anatomical sections of the “Korean Visible Human” for educational purposes. Material and Methods: The anatomical subject was a 33-year-old Korean man who died of leukemia. He was 164 cm tall and weighed 55 kg. This man donated his body to science. Her body was frozen and cut into several anatomical sections after an MRI and CT scan. These anatomical sections were made using a special saw called a 0.2 mm thick cryomacrotome. Thus 8100 cuts were obtained. Only the sections numbered 940 to 1200 were used for our study. A segmentation by manual contouring of the different parts of the typical cervical vertebra was made using the software Winsurf version 3.5 on a laptop PC running Windows 7 equipped with a Ram of 8 gigas. Results: Our 3D vector model of the typical cervical vertebra is easily manipulated using the Acrobat 3DPDF interface. Each part of the vertebra accessible in a menu can be displayed, hidden or made transparent, and 3D labels are available as well as educational menus for learning anatomy. Conclusion: This original work constitutes a remarkable educational tool for the anatomical study of the typical cervical vertebra and can also be used as a 3D atlas for simulation purposes for training in therapeutic gestures.

B lymphocytes inactivation by Ibrutinib limits endometriosis progression in mice.

What are the effects of B lymphocyte inactivation or depletion on the progression of endometriosis? Skewing activated B cells toward regulatory B cells (Bregs) by Bruton's tyrosine kinase (Btk) inhibition using Ibrutinib prevents endometriosis progression in mice while B cell depletion using an anti-CD20 antibody has no effect. A polyclonal activation of B cells and the presence of anti-endometrial autoantibodies have been described in a large proportion of women with endometriosis though their exact role in the disease mechanisms remains unclear. This study included comparison of endometriosis progression for 21days in control mice versus animals treated with the anti-CD20 depleting antibody or with the Btk inhibitor Ibrutinib that prevents B cell activation. After syngeneic endometrial transplantation, murine endometriotic lesions were compared between treated and control mice using volume, weight, ultrasonography, histology and target genes expression in lesions. Phenotyping of activated and regulatory B cells, T lymphocytes and macrophages was performed by flow cytometry on isolated spleen and peritoneal cells. Cytokines were assayed by ELISA. Btk inhibitor Ibrutinib prevented lesion growth, reduced mRNA expression of cyclooxygenase-2, alpha smooth muscle actin and type I collagen in the lesions and skewed activated B cells toward Bregs in the spleen and peritoneal cavity of mice with endometriosis. In addition, the number of M2 macrophages decreased in the peritoneal cavity of Ibrutinib-treated mice compared to anti-CD20 and control mice. Depletion of B cells using an anti-CD20 antibody had no effect on activity and growth of endometriotic lesions and neither on the macrophages, compared to control mice. N/A. It is still unclear whether B cell depletion by the anti-CD20 or inactivation by Ibrutinib can prevent establishment and/or progression of endometriosis in humans. Further investigation may contribute to clarifying the role of B cell subsets in human endometriosis. This research was supported by a grant of Institut National de la Santé et de la Recherche Médicale and Paris Descartes University. None of the authors has any conflict of interest to disclose.

Facial nerve morphogenesis: three‐dimensional and multiplanar study

The purpose of this study was to describe the facial nerve embryology, using three‐dimensional reconstructions from human embryos histological sections, and to compare our results with literature. Human embryos stage 13 to 21 from Carnegie collection and Paris‐Descartes University's Delmas‐Rouvière collection stained with hematoxylin & eosin or Masson's trichrome were used. A local made computer software developed by IADI lab (INSERM U947, Nancy) allowed automatic slices selection, automatic rigid registration, and dust filtering. Once registration had been completed, DICOM files were used with ORS Visual software (v1.5, Montreal), which allowed multiple display and post‐processing possibilities (3D VR; orthogonal/curved multiplanar reformation). Due to large size files, image processing was performed on PC with Windows 7 (64 bit) and 20 GB RAM. Three‐dimensional and multiplanar study of the facial nerve morphogenesis was possible with appropriate thresholding. The size, shape and positional changes of the facial nerve, geniculate ganglion, greater petrosal nerve and chorda tympanic relative to the external and middle ear were studied. Human embryonic facial nerve morphogenesis works are very rare because of the smallness of this anatomical structure. Our study using historic human embryos histological sections has shown the facial nerve growth. The precise knowledge of this morphogenesis will help to better understand congenital malformations.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Highlight on Endothelial Activation and Beyond.

Highlight on Endothelial Activation and Beyond.

851P - Pharmacokinetic/pharmacodynamic relationship of enzalutamide and its active metabolite N-desmethyl enzalutamide in metastatic castration-resistant prostate cancer patients

Background: Enzalutamide (ENZA) is an oral androgen receptor inhibitor approved for the treatment of metastatic Castration-Resistant Prostate Cancer (mCRPC). ENZA is extensively metabolized by CYP 3A4 into N-desmethyl enzalutamide (NDE). Based on in vitro assays, NDE has been identified as pharmacologically active metabolite. We aimed to explore the relationship between ENZA, NDE plasma concentration and progression-free survival (PFS) in mCRPC. Methods: Trough plasma concentrations of ENZA and NDE were measured at steady-state one month after treatment start, using liquid chromatography. Trough ENZA and NDE plasma concentrations were dichotomized into 2 groups (high and low) according to their median value. Progression was defined as clinical progression, PSA increase or imaging progression according to the prostate working group criteria 3 or death. A survival analysis was used to explore relationship between PFS and plasma drug exposure. Results: From January 2015 to May 2017, 18 mCRPC patients treated with ENZA (median age 77.5 years, Interquartile range (IQR) 67.2-82.7) were prospectively included. Median follow-up was 10.6 months (ms) (IQR 5.1-21.3 ms). Median trough plasma concentration of ENZA and NDE were 10.5 ± 3.7 µg/mL (Coefficient of variation (CV) = 33.8%; IQR 8.2-13.2) and 8.1 ± 4.2 µg/mL (CV = 52.7%; IQR 5,4-10,1), respectively. Pearson correlation coefficient value was 0,3 (p = 0.21). Eleven patients (61%) achieved a PSA response. Median PFS in the whole cohort was 11.2 ms (IQR 3.4-12.4). High trough plasma concentration of ENZA was associated with a shorter PFS (9 ms vs 22.6 ms respectively in the high and the low group) (Hazard Ratio (HR) 0.2; 95% CI 0.04-0.57; p = 0.005). Conversely, a high trough plasma concentration of NDE was associated with a longer PFS: 12,8 ms vs 7.2 ms respectively in the high and low group (HR 3.04; 95% CI 1.19-48.45; p = 0.03). Conclusions: Overall, these results suggest that NDE could be more pharmacologically active than ENZA in vivo. Plasma monitoring of ENZA and NDE could lead to early identification of patients who will not benefit from ENZA as well as to optimize their treatment choice. Legal entity responsible for the study: Department of Medical Oncology, Cochin Hospital, Paris Descartes University, Pr Goldwasser. Funding: Has not received any funding. Disclosure: O. Huillard: Consultant/advisor: Astellas Pharma, Sanofi, Janssen Oncology, Bristol-Myers Squibb; Travel, accommodations reimburse: Roche/Genentech, Astellas Pharma, Pfizer; Sanofi. F. Goldwasser: Consultant/advisor: Fresenius Kabi, Baxter. J. Alexandre: Consultant/advisor: Novartis, Roche; Honoraria: Novartis, AstraZeneca, Roche, Ipsen; Research funding: Jansen; Travel, accommodations reimburse: Jansen. All other authors have declared no conflicts of interest.

Epidemiology in sickle cell disease. Lessons learned from the CADRE cohort in Africa

Paris Descartes University, Paris, France This is an open access Abstract Book distributed under the Attribution-NonCommercial-NoDerivs (CCBY-NC-ND), which allows third parties to download the abstracts and share them with others as long as they credit the author and the abstract book, but they cannot change the content in any way or use them commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

The spleen: Neglected but essential

Paris Descartes University, Paris, France This is an open access Abstract Book distributed under the Attribution-NonCommercial-NoDerivs (CCBY-NC-ND), which allows third parties to download the abstracts and share them with others as long as they credit the author and the abstract book, but they cannot change the content in any way or use them commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

Meet the First Authors.

Meet the First Authors.

How to improve medical students’ knowledge using a social network?

The recent expansion of e-learning in universities could serve to improve students’ knowledge through pedagogic educational tools. Our aim was to develop a new, easy-to-use, daily learning management system to improve students’ knowledge in cardiology. We developed a database of 258 multiple choice questions (MCQ) for the medical students of Paris Descartes University. MCQs were sent daily through a specific social network and adapted to individual students’ needs to provide personalized follow-up. A final evaluation was performed at 3 months, including 25 previously sent (part 1: 25 points [pts]) and 25 new MCQs (part 2: 25 pts). We compared the results of this final evaluation according to daily participation of each student. A total of 255 medical students (64% female) participated in the MCQ program, with a daily participation rate of 71%. A total of 58.8% of the students were in year 6, 25.5% in year 5, and 15.7% in year 4. As much as 63% used their smartphone and 37% used their desktop to answer the MCQs. Time to answer an MCQS was 50 ± 4 seconds. The proportion of right answers overall was 26% . Finally, 190 students underwent the final evaluation. There was a positive correlation between participation rate and score to the evaluation (R 2 = 0.28, P < 0.001). This correlation was verified in each part of this evaluation, with best correlation in Part 1 than in Part 2. Furthermore, students with a daily participation rate > 90% had a better score than students with participation rate < 10% (26.3 ± 7.1 pts vs. 13.2 ± 7.5 pts, P < 0.0001) ( Fig. 1 ). This study suggests that our learning management system was well adopted by the medical students with a high rate of daily. The program was most effective for the students with the higher rate of daily participation implying that it is an effective tool to improve students’ knowledge. A mobile application of the program is being developed and will be tested in a larger population of medical students.

Meet the First Authors.

Meet the First Authors.

Meet the First Authors.

Dr Francesco Spallotta is a senior postdoctoral fellow at Goethe University, Frankfurt am Main (Germany), working in Dr Gaetano’s lab in the Division of Cardiovascular Epigenetics. He earned his MSc in Medical Biotechnology and his PhD in Experimental Medicine at Sapienza University, Rome (Italy). Since 2005, he is actively working in the field of epigenetics to elucidate new molecular mechanisms involved in human diseases. Recently, he started broadening his scientific horizons, attempting to characterize the link between metabolic alterations and epigenetic enzyme function in the context of metabolically altered environments and in the presence of the so-called “hyperglycemic memory.” To this aim, he took advantage of integrative bioinformatics analysis of multi-OMIC data derived from cardiac mesenchymal cells isolated from type 2 diabetic donors. For this study, the Functional Genomics Translational Biology (FGTB) council awarded him the FGTB Young Investigator Award during American Heart Association Scientific Session 2016 in New Orleans. His research goal is to shed light on novel epi-metabolic mechanisms underpinning human disease. During his leisure time, he enjoys wine tasting. He loves travelling around the world, going to vinyl shops looking for rarities, and supporting his Italian soccer team, “AS Roma.” Dr Wared Nour-Eldine earned an MS in Molecular Biology from the Lebanese University, Lebanon, in 2013, and a PhD in Immunology from Paris Descartes University, Paris, in 2017. …

Promoting empathy among medical students: A two-site randomized controlled study

ObjectiveTo assess the effects of Balint groups on empathy measured by the Consultation And Relational Empathy Measure (CARE) scale rated by standardized patients during objective structured clinical examination and self-rated Jefferson's School Empathy Scale - Medical Student (JSPE-MS©) among fourth-year medical students. MethodsA two-site randomized controlled trial were planned, from October 2015 to December 2015 at Paris Diderot and Paris Descartes University, France. Eligible students were fourth-year students who gave their consent to participate. Participants were allocated in equal proportion to the intervention group or to the control group. Participants in the intervention group received a training of 7 sessions of 1.5-hour Balint groups, over 3months. The main outcomes were CARE and the JSPE-MS© scores at follow-up. ResultsData from 299 out of 352 randomized participants were analyzed: 155 in the intervention group and 144 in the control group, with no differences in baseline measures. There was no significant difference in CARE score at follow-up between the two groups (P=0.49). The intervention group displayed significantly higher JSPE-MS© score at follow-up than the control group [Mean (SD): 111.9 (10.6) versus 107.7 (12.7), P=0.002]. The JSPE-MS© score increased from baseline to follow-up in the intervention group, whereas it decreased in the control group [1.5 (9.1) versus −1.8 (10.8), P=0.006]. ConclusionsBalint groups may contribute to promote clinical empathy among medical students.Trial registration: NCT02681380