Background
Prior clinical trials have suggested that home‐based Ig treatment in multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and its variant ...Lewis–Sumner syndrome (LSS) is safe and effective and is less costly than hospital‐administered intravenous immunoglobulin (IVIg).
Methods
A French prospective, dual‐center, cost minimization analysis was carried out to evaluate IVIg administration (5% concentrated) at home versus in hospital with regard to costs, patients’ autonomy, and patients’ quality of life. The primary endpoint was the overall cost of treatment, and we adopted the perspective of the payer (French Social Health Insurance).
Results
Twenty‐four patients aged 52.3 (12.2) years were analyzed: nine patients with MMN, eight with CIDP, and seven with LSS. IVIg (g/kg) dosage was 1.51 ± 0.43 in hospital and 1.52 ± 0.4 at home. Nine‐month total costs per patient extrapolated to 1 year of treatment were €48,189 ± 26,105 versus €91,798 ± 51,125 in the home and hospital groups, respectively (p < .0001). The most frequently reported factors for choosing home treatment were the good tolerance and absence of side effects of IVIg administration, as well as a good understanding of the advantages and drawbacks of home treatment (75% of respondents). The mRankin scores before and after switch to home treatment were 1.61 ± 0.72 and 1.36 ± 0.76, respectively (p = .027).
Discussion
The switch from hospital‐based to home‐based IVIg treatment for patients with immune neuropathy represents potentially significant savings in the management of the disease.
A French prospective, dual‐center analysis was carried out to evaluate IVIg administration (5% concentrated) at home versus in hospital in patients with autoimmune neuropathies. In patients deemed eligible for the switch, home treatment reduced costs from an average of €91,000 down to €48,000 per patient and was associated with better quality of life and patient satisfaction.
The efficacy of intravenous immunoglobulins (IVIg) in patients with autoimmune diseases (AID) has been known for several decades. Majority of these patients received IVIg in hospital. A retrospective ...study was conducted in 22 centers in France to evaluate the feasibility of the administration of Tegeline, an IVIg from LFB Biomedicaments, and assess its safety at home, compared to in hospital, in patients with AID. The included patients were at least 18 years old, suffering from AID, and treated with at least 1 cycle of Tegeline at home after receiving 3 consecutive cycles of hospital-based treatment with Tegeline at a dose between 1 and 2 g/kg/cycle. Forty-six patients with AID, in most cases immune-mediated neuropathies, received a total of 138 cycles of Tegeline in hospital and then 323 at home. Forty-five drug-related adverse events occurred in 17 patients who received their cycles at home compared to 24 adverse events in hospital in 15 patients. Serious adverse events occurred in 3 patients during home treatment, but they were not life-threatening and did not lead to discontinuation of Tegeline. Forty-five patients continued their treatment with Tegeline at home or in hospital; 39 (84.8%) were still receiving home treatment at the end of the study. In conclusion, the study demonstrates the good safety profile of Tegeline administered at home at high doses in patients with AID who are eligible for home administration of Tegeline.
To assess the efficacy and safety of intraveinous immunoglobulin (IV Ig) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) at 4, 7 and 12months.
A national multicenter ...retrospective study was conducted by LFB Biotehcnologies in patients with CIDP who had received at least one cycle of a 5% polyvalent IV Ig, Tegeline®, from LFB biomédicaments between 1995 and 2004. The primary endpoint was the efficacy of IV Ig at 4 months, which was defined as the responder rate based on the modified Rankin scale. Several secondary endpoints were assessed: safety and efficacy (i.e., responders according to the investigators’ overall assessment of the patients’ status) at 4, 7 and 12 months. The analysis was performed at 7 months only (due to missing data for 12 months and few patients).
A total of 26 patients were included who had received between 1 and 6 cycles of IV Ig (mean 3±2) with a median follow-up of 9.9 months. The responder rate at 4 months based on the modified Rankin scale was 52% (95% CI 0.313–0.722), whereas the responder rate with placebo reported in the literature (meta-analysis including results from van Schaik and an ICE study) is 18% (P<0.001). Responder patients at 4 months were still responders at 7 months. The overall safety of IV Ig was good, with adverse events of mild to moderate severity, which resolved without sequelae and were expected adverse events of IV Ig.
This retrospective study confirmed both the efficacy of IV Ig at 4 months in the treatment of chronic inflammatory demyelinating polyneuropathy and the favorable safety profile of the product.
Évaluer l’efficacité et la tolérance de Tégéline® chez des patients atteints de polyradiculonévrite inflammatoire démyélinisante chronique (PIDC) à 4, 7 et 12 mois.
Une étude rétrospective multicentrique nationale fut conduite par LFB Biotechnologies chez des patients atteints de PIDC et ayant reçu au moins une cure de Tégéline®, immunoglobulines intraveineuses (IgIV) polyvalentes à 5 % du laboratoire LFB, entre 1995 et 2004. Le critère principal de jugement était l’efficacité de Tégéline® à 4 mois, défini par le taux de répondeurs selon le score de Rankin modifié. Plusieurs critères secondaires de jugement étaient étudiés : la tolérance et l’efficacité (répondeur selon l’évaluation globale de l’état du patient par l’investigateur) à 4, 7 et 12 mois. L’analyse a été conduite à 7 mois seulement (à cause de données manquantes à 12 mois et du peu de patients).
Vingt-six patients ont été inclus ayant reçu entre 1 et 6 cures de Tégéline® (moyenne=3±2) avec une médiane de suivi de 9,9 mois. Le taux de répondeurs à 4 mois selon le score de Rankin modifié était de 52 % (IC 95 %=0,313–0,722) alors que le taux de répondeurs sous placebo rapporté dans la littérature (méta-analyse incluant les résultats de van Schaik et de l’étude ICE) est de 18 % (p<0,001). L’évaluation globale de l’état du patient par l’investigateur à 4 mois retrouve un taux de répondeurs de 85,7 %. Les patients répondeurs à 4 mois étaient toujours répondeurs à 7 mois. La tolérance de Tégéline® fut globalement bonne avec des effets indésirables d’intensité légère ou modérée, de résolution sans séquelle et correspondant aux effets indésirables attendus des IgIV.
Cette étude rétrospective confirme l’efficacité de Tégéline® à 4 mois dans le traitement des polyradiculonévrites inflammatoires démyélinisantes chroniques avec un bon profil de tolérance du produit.
In this paper, we present the investigation of narrow-width effects (NWEs) on partially depleted (PD) silicon-on-insulator (SOI) with different gate shape topologies. Based on dc/ac measurements and ...TCAD simulations, it shows detailed clarifications of body-tied-induced NWEs. The overall study demonstrates relationship between gate shape topologies, body-tied shape, and electrical width of the transistor. Provided physical-based analytical models are able to capture peak GM and C GG as function of gate length, transistor width, physical gate-overlap width, and number of body tied. This results in improving the overall model accuracy of body contact and floating-body PD SOI MOSFETs.
Les déficits immunitaires primitifs humoraux (DIH) regroupent un ensemble hétérogène de maladies rares qui se manifestent par une susceptibilité accrue aux infections, souvent accompagnée d’un ...cortège de phénomènes immunopathologiques (auto-immunité, inflammation, lymphoproliférations bénignes ou malignes). La prévalence précise des DIH en France n’est pas connue mais on estime qu’ils représenteraient environ 5 000 patients.
Afin de mieux comprendre la situation des DIH en France et d’obtenir une appréciation de la prise en charge de ces patients, nous avons conduit une enquête quantitative, nationale, fondée sur l’envoi d’un questionnaire aux médecins susceptibles de prendre en charge des patients atteints de DIH.
L’analyse des questionnaires obtenus fait ressortir que la plupart des médecins prenant en charge des DIH voyaient peu de patients atteints mais que les conduites diagnostiques et thérapeutiques étaient dans l’ensemble satisfaisantes.
Ces résultats soulignent la nécessité de coordonner la prise en charge des patients atteints de DIP en France dans le cadre de réseaux nationaux. L’approche adoptée par le CEREDIH (Centre de Référence Déficits Immunitaires Héréditaires) et la cohorte DEF-I recensant les patients avec DIH, permettra d’optimiser la prise en charge des DIH, en définissant des recommandations diagnostiques et thérapeutiques. En outre, ces réseaux permettront de mieux comprendre l’incidence des DIH et de leurs complications.
Primary Immunodeficiencies (PIDs) represent a heterogeneous group of rare diseases characterized by increased susceptibility to infections, often accompanied by a diverse immuno-pathological manifestations (autoimmunity, inflammation, benign or malignant lymphoproliferative disorders). The precise prevalence of PIDs in France is not known but is estimated to represent approximately 5 000 patients.
To better understand the situation of PID in France and gain an insight as to the care of these patients, we conducted a national survey by sending a questionnaire to physicians potentially involved in the care of PID patients.
The majority of physicians follow only a few PID patients but the diagnostic and therapeutic attitudes are generally satisfactory.
These results underscore the need to coordinate the care of PID patients in France as part of national networks. The approach adopted by the CEREDIH (French reference center for hereditary immune deficiencies) and DEF-I french national cohort identifying patients with DIP, will optimize the management of PID by defining diagnostic and therapeutic guidelines. In addition, these networks will provide valuable data regarding the incidence of PID and their complications.
CMOS evolution at Moore’s law speed modulated by market demand is facing extrinsic and intrinsic limitations. Main extrinsic drawback is process variability affecting yield production. Solutions to ...address this point are focused on design and integration at dice level. Intrinsic limitations are usually summarized through the term
Short
Channel
Effects,
SCE. To overcome parasitic SCE, device engineers consider building aggressively shrink CMOS transistors on thin silicon film. These devices, allow a better electrostatic potential control.
New memory cell architecture can be evaluated on thin film technologies following CMOS evolution. Recent literature reports many efforts to utilize floating body effect
1,2 to enable volatile and non volatile memories. In this study we present how one transistor built on thin film can be considered for volatile and non volatile memory applications.
Memory effects are electrically evaluated on thin
Buried
Oxide,
BOx,
Fully
Depleted
SOI,
FDSOI, devices of sub 75
nm gate length.
This paper details the modeling of a one-transistor dynamic random-access memory (1TDRAM) based on an independent double-gate device. A pseudo-2-D compact model of memory operations and dynamic ...behavior of data retention is proposed. The physical mechanisms involved are calculated through the accumulated charge in the body modulated by quantum effects related to thin silicon films. The resulting currents from programming operations are detailed. We consider current leakages, generation/recombination, and band-to-band tunneling parasitic effects for data retention.
Primary Immunodeficiencies (PIDs) represent a heterogeneous group of rare diseases characterized by increased susceptibility to infections, often accompanied by a diverse immuno-pathological ...manifestations (autoimmunity, inflammation, benign or malignant lymphoproliferative disorders). The precise prevalence of PIDs in France is not known but is estimated to represent approximately 5 000 patients.
To better understand the situation of PID in France and gain an insight as to the care of these patients, we conducted a national survey by sending a questionnaire to physicians potentially involved in the care of PID patients.
The majority of physicians follow only a few PID patients but the diagnostic and therapeutic attitudes are generally satisfactory.
These results underscore the need to coordinate the care of PID patients in France as part of national networks. The approach adopted by the CEREDIH (French reference center for hereditary immune deficiencies) and DEF-I french national cohort identifying patients with DIP, will optimize the management of PID by defining diagnostic and therapeutic guidelines. In addition, these networks will provide valuable data regarding the incidence of PID and their complications.
Background: Cyclosporine A (CsA) nephrotoxicity is a non‐immunologic factor of chronic allograft dysfunction (CAD) in kidney transplant recipients. Mycophenolate mofetil (MMF) may allow CsA dosage ...reduction or even complete withdrawal in selected populations with CsA nephrotoxicity or CAD. The aim of the present study was to evaluate the efficacy and safety of CsA withdrawal after azathioprine (AZA)‐MMF conversion in a population of stable renal transplant recipients. Methods: Twenty‐eight first cadaver kidney recipients were included. AZA was then discontinued, MMF was introduced and after 4 months CsA was completely withdrawn. All patients underwent inuline clearance measurement and renal biopsy at inclusion and at the end of the follow‐up (40 wk). Results: CsA was completely discontinued in 20 patients. No patient lost his graft during the study period, but 1 patient experienced a reversible acute rejection episode. Inuline clearance improved significantly in the whole series. At the end of follow‐up, histological worsening was observed in 50% of patients without any specific risk factor. In these patients, inuline clearance did not improve. Systolic blood pressure, the need for anti‐hypertensive drugs and HDL cholesterol improved. Conclusion: In stable kidney transplant recipients, CsA withdrawal after AZA replacement by MMF switch was safe with regard to acute rejection. It improved blood pressure and the lipid profile, but, in 50% of patients was associated with histologic deterioration.
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