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Bordenave M, Rouprêt M, Taksin L, Parra J, Cour F, Richard F, Bitker MO, Chartier-Kastler E. [Long-term results of the treatment of urinary incontinence with bulbar implantation of artificial urinary sphincter in men: a single-center experience]. Prog Urol 2010; 21:277-82. [PMID: 21482403 DOI: 10.1016/j.purol.2010.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Revised: 05/18/2010] [Accepted: 07/03/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To report the functional results and morbidity after implantation of bulbar artificial urinary sphincter (AUS) in incontinent men with at least 5 years of follow-up. PATIENTS AND METHODS The files of patients treated between 1984 and 2003 by setting up a SAU at bulbar location were reviewed. The following data were recorded: age, etiology of incontinence, intra-operative complications. To evaluate the results on continence, patients were seen at 1, 3, 6 and 12 months, and yearly thereafter. RESULTS Overall, 159 men implanted with an AUS were included. The median age was 68.4 years and the median follow-up was 69 months. The etiology of incontinence was a prostate surgery in 83% of cases. The five-year rates of continence and satisfaction were 74.2% (n=118) and 92% (n=140), respectively. The five-year rates of infections and erosions were 4.4% and 9.4%, respectively. In case of previous radiotherapy, the rate of erosion at 5 years was 22.2%. The rate of atrophy and urethral mechanical failure at 5 years was 7.5% and 23.6%, respectively. The rate of reoperation at 5 years was 41.5%. CONCLUSION Our results confirm that the AUS is still the standard treatment for male with urinary incontinence due to intrinsic sphincter deficiency. Minimally invasive therapies are being developed that could overcome the mechanical failures and offer an alternative in case of primary or even secondary failure of the AUS.
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Guillemet R, Guérin C, Richard F, Dourmad JY, Meunier-Salaün MC. Feed transition between gestation and lactation is exhibited earlier in sows fed a high-fiber diet during gestation1. J Anim Sci 2010; 88:2637-47. [DOI: 10.2527/jas.2009-2307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bah O, Roupret M, Guirassy S, Diallo A, Diallo M, Richard F. Aspects cliniques et thérapeutiques de la torsion du cordon spermatique : étude de 27 cas. Prog Urol 2010; 20:527-31. [DOI: 10.1016/j.purol.2009.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 12/08/2009] [Accepted: 12/11/2009] [Indexed: 10/19/2022]
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Billault C, Rolland E, Vaessen C, Van Glabeke E, Gouezo R, Richard F, Barrou B. Faut-il monitorer la température pendant la phase de préservation en transplantation rénale ? Prog Urol 2010; 20:430-4. [DOI: 10.1016/j.purol.2009.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 10/28/2009] [Accepted: 11/27/2009] [Indexed: 11/16/2022]
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Ligier K, Leroy X, Martin P, Clisant S, Richard F, Penel N. Adult sarcomas: Incidence and initial management before implantation of regional sarcoma committee in northern France. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e20522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Audouin M, Beley S, Cour F, Vaessen C, Chartier-Kastler E, Bitker MO, Richard F, Rouprêt M. Dysfonction érectile après prostatectomie totale : physiopathologie, évaluation et traitement. Prog Urol 2010; 20:172-82. [DOI: 10.1016/j.purol.2009.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Revised: 06/07/2009] [Accepted: 06/17/2009] [Indexed: 10/20/2022]
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Alenda O, Beley S, Ferhi K, Cour F, Chartier-Kastler E, Haertig A, Richard F, Rouprêt M. Physiopathologie et prise en charge de la maladie de La Peyronie. Prog Urol 2010; 20:91-100. [DOI: 10.1016/j.purol.2009.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 04/22/2009] [Accepted: 05/29/2009] [Indexed: 11/26/2022]
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Ferhi K, Rouprêt M, Rode J, Misraï V, Lebeau T, Richard F, Vaessen C. [Technical aspects of laparoscopic robot-assisted pyeloplasty]. Prog Urol 2009; 19:606-10. [PMID: 19800549 DOI: 10.1016/j.purol.2009.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2008] [Revised: 02/01/2009] [Accepted: 04/06/2009] [Indexed: 11/29/2022]
Abstract
From 2000, the robot-assisted laparoscopic approach has been developed for the management of ureteropelvic junction obstruction (UJO) with equivalent outcomes to conventional laparoscopic access regarding functional results. This system has simplified the suturing and has improved the precision of operative technique. The main surgical steps of the transperitoneal laparoscopic robot-assisted pyeloplasty are as follows: four or five port arrangement; initial dissection and early identification of the ureteropelvic junction; renal pelvis section; transection of the ureter and preparation of a spatula; continuous posterior suture; confection of a handle racket suture; placement of a double J stent; ending of the anastomosis. Outcomes after robotic and pure laparoscopic pyeloplasties are equivalent nowadays. Despite the financial cost, it seems easier and technically feasible and accessible for surgeons accustomed to the laparoscopic techniques and even beginners to learn the robotic technique if the system is available in their institution with success rate (radiologic and clinical) almost similar with those obtain with open techniques.
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Lambert JC, Schraen-Maschke S, Richard F, Fievet N, Rouaud O, Berr C, Dartigues JF, Tzourio C, Alpérovitch A, Buée L, Amouyel P. Association of plasma amyloid beta with risk of dementia: the prospective Three-City Study. Neurology 2009; 73:847-53. [PMID: 19752451 DOI: 10.1212/wnl.0b013e3181b78448] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Several lines of evidence indicate that a decrease in the CSF concentration of amyloid beta(42) (Abeta(42)) is a potential biomarker for incident Alzheimer disease. In contrast, studies on plasma Abeta(1-40) and Abeta(1-42) peptide levels have yielded contradictory results. Here, we explored the links between incident dementia and plasma Abeta(1-40) and Abeta(1-42) peptide concentrations in the prospective, population-based Three-City (3C) Study. We also assessed the association between plasma concentrations of truncated Abeta (Abeta(n-40) and Abeta(n-42)) and the risk of dementia. METHODS During a subsequent 4-year follow-up period, 257 individuals presented incident dementia from 8,414 participants, and a subcohort of 1,185 individuals without dementia was drawn as a control cohort. Plasma levels of Abeta(1-40), Abeta(1-42), Abeta(n-40), and Abeta(n-42) were measured using an xMAP-based assay technology. The association between plasma Abeta peptide levels and the risk of dementia was assessed using Cox proportional hazard models. RESULTS Of the various Abeta variables analyzed, the Abeta(1-42)/Abeta(1-40) and Abeta(n-42)/Abeta(n-40) ratios presented the strongest association with the risk of dementia: people with a high Abeta(1-42)/Abeta(1-40) or Abeta(n-42)/Abeta(n-40) ratio had a lower risk of developing dementia. These associations were restricted to individuals diagnosed at 2 years of follow-up and the Abeta(n-42)/Abeta(n-40) ratio was mainly associated with the risk of mixed/vascular dementia. CONCLUSION Plasma Abeta peptide concentrations and Abeta(1-42)/Abeta(1-40) and Abeta(n-42)/Abeta(n-40) ratios may be useful markers to indicate individuals susceptible to short-term risk of dementia.
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Deschaintre Y, Richard F, Leys D, Pasquier F. Treatment of vascular risk factors is associated with slower decline in Alzheimer disease. Neurology 2009; 73:674-80. [DOI: 10.1212/wnl.0b013e3181b59bf3] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Richard F. Dépistage du cancer de la prostate : les données du premier tour de dépistage de la population française participant à l’essai européen ERSPC. Prog Urol 2009; 19:499-500. [DOI: 10.1016/j.purol.2009.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 04/24/2009] [Indexed: 10/20/2022]
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Richard F, Garel C, Cynober E, Soupre V, Bénifla JL, Jouannic JM. Prenatal diagnosis of a rapidly involuting congenital hemangioma (RICH) of the skull. Prenat Diagn 2009; 29:533-5. [DOI: 10.1002/pd.2221] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Zerbib J, Leveziel N, Richard F, Feingold J, Puche N, Coscas G, Soubrane G, Munnich A, Kaplan J, Rozet J, Souied E. 288 Étude de gènes candidats dans la Dégénérescence Maculaire Liée à l’Âge chez des patients ne portant pas les variants à risque pour les gènes CFH et LOC387715 (ARMS2). J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73411-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Billault C, Vaessen C, Van Glabeke E, Culty T, Arzouk N, Dumitru L, Ourahma S, Robert J, Richard F, Barrou B. Systematic microbiological tests in kidney transplantation and their value in predicting posttransplantation infection. Transplant Proc 2009; 41:666-8. [PMID: 19328951 DOI: 10.1016/j.transproceed.2008.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Immunosuppressive therapy has many side effects among which is an increased infectious risk for the recipient. Transmission of pathogens from the graft to the recipient has not been well evaluated; there are no guidelines regarding the need for microbiological tests on the graft prior to transplantation. We routinely performed such tests to evaluate the risk and determine whether a patient should receive preemptive antibiotic therapy after transplantation. We herein have reported our preliminary results. MATERIALS AND METHODS We reviewed 150 consecutive renal transplantations from cadaveric heart-beating donors. Microbiological tests were systematically performed not only on the preservation solution, but also on graft artery, vein, ureter, and perirenal fat. We reviewed the recipient's medical history for clinically significant infectious episodes in the first month after transplantation. RESULTS Thirty-one percent of all microbiological tests were positive with 23 patients showing multiple positive tests, 74% of which were concordant. We documented 3 cases of direct graft-to-recipient pathogen transmission, all of which presented with 3 positive concordant tests. Graft culture prior to transplantation is often positive, but in more than half of the cases positive tests are either isolated or discordant. We only treated patients with concordant test results; no adverse consequence was observed among the untreated patients. Transmission occurred only in patients with at least 3 concordant tests. CONCLUSIONS Multiple microbiological tests on the graft prior to transplantation seemed useful to determine which patients would benefit from preemptive antibiotic therapy. Further studies may help to define which microbiological tests are the most important.
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Xylinas E, Misraï V, Comperat E, Renard-Penna R, Vaessen C, Bitker MO, Chartier-Kastler E, Richard F, Cussenot O, Rouprêt M. [Oncologic and functional outcomes after radical prostatectomy in T3 prostate cancer]. Prog Urol 2009; 19:285-90. [PMID: 19393531 DOI: 10.1016/j.purol.2009.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2008] [Revised: 11/14/2008] [Accepted: 01/22/2009] [Indexed: 12/22/2022]
Abstract
According to current literature, the gold standard treatment for T3 prostate cancer is the combination of radiotherapy and extended hormonotherapy. Clinical staging based on digital rectal examination seems useless nowadays, since 20% of T3 prostate cancer is overevaluated during physical examination. Prostatic MRI is extensively needed to evaluate extraprostatic extension during preoperative work-up. EAU guidelines recommend radical prostatecomy only in selected patients: less than or equal to cT3a, PSA less than 20 ng/ml and biopsy Gleason score less than or equal to 8. Carcinologic control obtained after radical prostatectomy is variable from one series to another, with biochemical free survival rate at 5, 10 and 15 years that range from 45 to 62%, 43 to 51%, and 38 to 49%. Specific survival rates at 5, 10 and 15 years are, respectively, of 84 to 98%, 85 to 91% and 76 to 84%. Surgical margins rate differ from 22 up to 61% corresponding to several operative techniques and surgeon's own experience. Regarding urinary continence, functional outcomes are in line with those of prostatectomy for localized prostate cancer. Considering erectile dysfunction, rates are linked with the type of surgery, which can be extensive or not. There is no impact on overall or specific survival of neoadjuvant treatments. One current question remains the efficacy of early adjuvant treatment after prostatectomy, especially adjuvant irradiation. Radical prostatectomy can be considered in selected cases as a viable alternative first-line treatment option. However, patients have to be warned that they may undergo complementary treatments during the postoperative course of the disease.
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Drouin SJ, Vaessen C, Misraï V, Ferhi K, Bitker MO, Chartier-Kastler E, Haertig A, Richard F, Rouprêt M. Résultats carcinologiques et fonctionnels de la prostatectomie totale laparoscopique robot-assistée. Prog Urol 2009; 19:158-64. [DOI: 10.1016/j.purol.2008.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 10/17/2008] [Accepted: 11/28/2008] [Indexed: 10/21/2022]
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Doerfler A, Vaessen C, Gosseine PN, Barrou B, Richard F. Laparoscopic Radical Prostatectomy in Kidney Transplant Patient: Our First Experience—A Case Report. Transplant Proc 2009; 41:713-5. [DOI: 10.1016/j.transproceed.2008.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bruandet A, Richard F, Bombois S, Maurage CA, Deramecourt V, Lebert F, Amouyel P, Pasquier F. Alzheimer disease with cerebrovascular disease and vascular dementia: clinical features and course compared with Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80:133-9. [PMID: 18977819 DOI: 10.1136/jnnp.2007.137851] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Vascular dementia (VaD) and Alzheimer disease with cerebrovascular disease (AD+CVD) are the leading causes of dementia after Alzheimer disease alone (AD). Little is known about the progression of either VaD or AD+CVD. The aim of this study was to compare demographic features, cognitive decline and survival of patients with VaD, AD+CVD and AD alone attending a memory clinic. METHODS This study included 970 patients who were followed at the Lille-Bailleul memory clinic, France. Cognitive functions were measured with the Mini Mental State Examination (MMSE) and the Dementia Rating Scale (DRS). Survival rate was analysed with a left-truncated Cox model. Analyses were adjusted for age, sex, education, hypertension, diabetes and baseline MMSE and DRS. RESULTS Of 970 patients, 141 had VaD, 663 AD alone and 166 AD+CVD. The latter were significantly older than AD or VaD patients at onset (71 (SD 7) vs 69 (9) and 68 (9) years, p = 0.01) and at first visit (75 (6) vs 73 (8) and 72 (8) years, p = 0.0002). Baseline MMSE and DRS evaluations were highest for VaD compared with AD alone or AD+CVD patients (p<0.006). Cognitive decline during follow-up was slowest for VaD, intermediate for AD+CVD and fastest for AD alone (p = 0.03). After adjustment, compared with AD patients, mortality risk was similar for those with VaD (relative mortality risk (RR) = 0.7 (0.5 to 1.1)) and tended to be lower for AD+CVD (RR = 0.7 (0.5 to 1.0)). The shorter the delay between first symptoms and first visit, the longer patients survived. CONCLUSION This clinical cohort study shows that patients with VaD, AD+CVD and AD present different characteristics at baseline and during follow-up, and underlines the need to distinguish between them.
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Pignot G, Galiano M, Hajage D, Rouprêt M, Pasqui F, Chartier-Kastler E, Bitker MO, Richard F. [Nephron sparing surgery for renal tumors on a solitary kidney: oncological outcomes and long-term functional evolution]. Prog Urol 2009; 19:94-100. [PMID: 19168011 DOI: 10.1016/j.purol.2008.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 10/18/2008] [Accepted: 10/21/2008] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Nephron sparing surgery raises the challenge of avoiding chronic haemodialysis for patients having malignancies on a solitary kidney. The aim of this study was to estimate the long term renal function, survival and risk of recurrence of patients undergoing elective nephron sparing surgery for renal cancer on a solitary kidney. MATERIAL AND METHODS Between January 1975 and December 2002, 37 elective nephron sparing surgery of kidney tumors were performed on 33 patients with a solitary kidney. Surgery was performed without interruption of blood flow. Pre- and postoperative renal function were compared by using a non parametric test of Kruskal and Wallis. Survival rates were estimated by the Kaplan Meier method and the prognostic factors were defined on a multivariate analysis using a Cox model. RESULTS Mean tumoral diameter was 4.6 cm [1.5-10]. The median follow-up was of 83 months. Three patients died in the postoperative period. The postoperative creatinine clairance was significantly lower than the preoperative value (p=0.01), but without significant variation of the renal dysfunction rate (p=0.18) and without significant decrease during the follow-up. No patient required chronic haemodialysis. Overall and disease-free survival rates at five and 10 years was 69 and 56.2%, and 55.8 and 27%, respectively. Multivariate analysis retained tumor size, Fuhrman grade and antecedent of controlateral cancer as independent prognostic factors in overall survival. CONCLUSION In our experience, even in the presence of bad prognostic factors, nephron sparing surgery allows a relative savings of the long term renal function. Taking in account the poor life expectancy of people around 60 being put on haemodialysis, all attempt should be made to perform nephron sparing surgery in patients having a cancer on a solitary kidney.
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Thibault F, Bart S, Rixe O, Comperat E, Renard R, Chartier-Kastler E, Richard F. Tumeur épithéliale primitive de la tête de l’épididyme. Prog Urol 2009; 19:66-8. [DOI: 10.1016/j.purol.2008.09.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Revised: 07/16/2008] [Accepted: 09/23/2008] [Indexed: 11/29/2022]
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Dohan A, Bart S, Renard-Penna R, Comperat E, Thibault F, Doerfler A, Richard F. Adénocarcinome ductal de la prostate, quatre ans de suivi. Prog Urol 2008; 18:1093-6. [DOI: 10.1016/j.purol.2008.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Revised: 07/28/2008] [Accepted: 08/01/2008] [Indexed: 10/21/2022]
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Misraï V, Rouprêt M, Seringe E, Vaessen C, Cour F, Haertig A, Richard F, Chartier-Kastler E. Résultats à long terme de la promontofixation laparoscopique dans les cystocèles de haut grade. Prog Urol 2008; 18:1068-74. [DOI: 10.1016/j.purol.2008.08.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Revised: 07/01/2008] [Accepted: 08/19/2008] [Indexed: 10/21/2022]
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Peycelon M, Vaessen C, Misraï V, Comperat E, Conort P, Bitker MO, Haertig A, Chartier-Kastler E, Richard F, Rouprêt M. [Results of nephron-sparing surgery for renal cell carcinoma of more than 4 cm in diameter]. Prog Urol 2008; 19:69-74. [PMID: 19168008 DOI: 10.1016/j.purol.2008.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 09/25/2008] [Accepted: 10/22/2008] [Indexed: 01/13/2023]
Abstract
To date, radical nephrectomy (RN) remains the gold standard treatment for renal cell carcinoma (RCC) larger than 4 cm. However, from the early 1990's, improvements in surgical techniques have lead to the development of nephron-sparing surgery (NSS) for small renal tumours of less than 4 cm in diameter. This surgical procedure avoids nephronic waste with an acceptable morbidity and similar oncological outcomes compared to radical surgery. Recent large published series did not show any difference between NSS and RN in terms of oncological safety. Specific and disease-free five-year survival rates (82% to 97.3% and 81% to 97.3%, respectively) have confirmed the safety of NSS. Regarding laparoscopic NSS, the technique is still under evaluation and only mid-term outcomes are available so far. However, these studies are still limited and longer follow-up is needed before any definitive statement can be made. Current guidelines recommend NSS only in case of RCC of less than 4 cm in diameter in elective indications. In daily practice however, surgical teams are pushing back the limit above the threshold of 4 cm. More and more surgeons are either considering anatomical location or technical expected difficulties rather than just the tumour size. NSS leads to higher risk of bleeding, especially in case of tumours larger than 4 cm. Therefore, it is absolutely necessary to investigate thoroughly the vascularization of the tumour to avoid such complications with exhaustive and accurate preoperative imaging.
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Richard F, Ouédraogo C, De Brouwere V. Quality cesarean delivery in Ouagadougou, Burkina Faso: a comprehensive approach. Int J Gynaecol Obstet 2008; 103:283-90. [PMID: 18992882 DOI: 10.1016/j.ijgo.2008.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 07/08/2008] [Accepted: 08/20/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the effects of a comprehensive intervention (staff training, equipment, internal clinical audits, cost sharing system, patients-providers meetings) in improving cesarean delivery access and quality in an urban district of Burkina Faso. METHODS We conducted a before-after study in the health district sector 30 in Ouagadougou between 2003 and 2006. We measured cesarean delivery quality (accessibility, diagnosis, procedure, postoperative follow-up) and maternal and neonatal health in 1371 sections. RESULTS The number of cesarean deliveries performed increased each year, from 42 in 2003 to 630 in 2006. This increase happened without increase in maternal and perinatal post-cesarean mortality (respectively 1.1% and 3.6% in 2006). The cesarean delivery rate for women of the district increased from 1.9% to 3.3% of expected births between 2003 and 2005. CONCLUSION To improve access to quality cesarean delivery, we have shown that it was necessary to have a systemic approach combining technical, operational, sociocultural, and political factors.
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Bruandet A, Richard F, Fievet N, Dartigues JF, Berr C, Tzourio C, Alpérovitch A, Amouyel P, Lambert JC. Association entre le gène S100β et le déclin cognitif chez les personnes âgées : l’étude des trois cités. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.06.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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