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Lagarde E, Gil-Jardiné C. The nosological wanderings of post-concussion syndrome. The epilogue is still to be written. Neurochirurgie 2020; 67:276-279. [PMID: 32067975 DOI: 10.1016/j.neuchi.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/15/2019] [Indexed: 11/19/2022]
Affiliation(s)
- E Lagarde
- Inserm, ISPED, Bordeaux Population Health Research Center Inserm U1219 "Injury Epidemiology Transport Occupation" team, Bordeaux cedex, France.
| | - C Gil-Jardiné
- University Hospital of Bordeaux, Pole of Emergency Medicine, Inserm, ISPED, Bordeaux Population Health Research Center Inserm U1219 "Injury Epidemiology Transport Occupation" team, Bordeaux cedex, France.
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Gil-Jardiné C, Al Joboory S, Jammes JTS, Durand G, Ribéreau-Gayon R, Galinski M, Salmi LR, Revel P, Régis CA, Valdenaire G, Poulet E, Tazarourte K, Lagarde E. Prevention of post-concussion-like symptoms in patients presenting at the emergency room, early single eye movement desensitization, and reprocessing intervention versus usual care: study protocol for a two-center randomized controlled trial. Trials 2018; 19:555. [PMID: 30314512 PMCID: PMC6186089 DOI: 10.1186/s13063-018-2902-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/04/2018] [Indexed: 01/04/2023] Open
Abstract
Background Recent data suggest that 10–20% of injury patients will suffer for several months after the event from diverse symptoms, generally referred to as post-concussion-like symptoms (PCLS), which will lead to a decline in quality of life. A preliminary randomized control trial suggested that this condition may be induced by the stress experienced during the event or emergency room (ER) stay and can be prevented in up to 75% of patients with a single, early, short eye movement desensitization and reprocessing (EMDR) psychotherapeutic session delivered in the ER. The protocol of the SOFTER 3 study was designed to compare the impact on 3-month PCLS of early EMDR intervention and usual care in patients presenting at the ER. Secondary outcomes included 3-month post-traumatic stress disorder, 12-month PCLS, self-reported stress at the ER, self-assessed recovery expectation at discharge and 3 months, and self-reported chronic pain at discharge and 3 months. Methods This is a two-group, open-label, multicenter, comparative, randomized controlled trial with 3- and 12-month phone follow-up for reports of persisting symptoms (PCLS and post-traumatic stress disorder). Those eligible for inclusion were adults (≥18 years old) presenting at the ER departments of the University Hospital of Bordeaux and University Hospital of Lyon, assessed as being at high risk of PCLS using a three-item scoring rule. The intervention groups were a (1) EMDR Recent Traumatic Episode Protocol intervention performed by a trained psychologist during ER stay or (2) usual care. The number of patients to be enrolled in each group was 223 to evidence a 15% decrease in PCLS prevalence in the EMDR group. Discussion In 2012, the year of the last national survey in France, 10.6 million people attended the ER, some of whom did so several times since 18 million visits were recorded in the same year. The SOFTER 3 study therefore addresses a major public health challenge. Trial registration Clinical Trials. NCT03400813. Registered 17 January 2018 – retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s13063-018-2902-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cédric Gil-Jardiné
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France. .,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France. .,Emergency Department, University Hospital of Bordeaux, Pellegrin Hospital, Place Amélie Raba-Léon, 33000, Bordeaux, France. .,Bordeaux University Hospital, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33400, Talence, France.
| | | | | | - Guillaume Durand
- Department of Emergency Medicine, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France.,University Hospital, Claude Bernard University, Lyon, France
| | - Régis Ribéreau-Gayon
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France.,University Hospital of Bordeaux, Pole of Medicine, Bordeaux, France
| | - Michel Galinski
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | - Louis-Rachid Salmi
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France.,University Hospital of Bordeaux, Pole of Public Health, Bordeaux, France
| | - Philippe Revel
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | | | - Guillaume Valdenaire
- University Hospital of Bordeaux, Pole of Emergency Medicine, Bordeaux, France.,INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
| | - Emmanuel Poulet
- University Hospital, Claude Bernard University, Lyon, France.,Department of Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France
| | - Karim Tazarourte
- Department of Emergency Medicine, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France.,EA 7425 Hesper University Hospital, Claude Bernard University, Lyon, France
| | - Emmanuel Lagarde
- INSERM, ISPED, Bordeaux Population Health research center INSERM U1219 - "Injury Epidemiology Transport Occupation" team, Bordeaux Cedex, France
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Gil-Jardiné C, Evrard G, Al Joboory S, Tortes Saint Jammes J, Masson F, Ribéreau-Gayon R, Galinski M, Salmi LR, Revel P, Régis CA, Valdenaire G, Lagarde E. Emergency room intervention to prevent post concussion-like symptoms and post-traumatic stress disorder. A pilot randomized controlled study of a brief eye movement desensitization and reprocessing intervention versus reassurance or usual care. J Psychiatr Res 2018; 103:229-236. [PMID: 29894921 DOI: 10.1016/j.jpsychires.2018.05.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 10/16/2022]
Abstract
Up to 20% of patients presenting at an emergency room (ER) after a stressful event will for several months suffer from very diverse long-lasting symptoms and a potentially significant decline in quality of life, often described as post concussion-like symptoms (PCLS). The objectives of our randomized open-label single-center study were to assess the feasibility of psychologist-led interventions in the context of the ER and to compare the effect of eye movement desensitization and reprocessing (EMDR) with reassurance and usual care. Conducted in the ER of Bordeaux University Hospital, the study included patients with a high risk of PCLS randomized in three groups: a 15-min reassurance session, a 60-min session of EMDR, and usual care. Main outcomes were the proportion of interventions that could be carried out and the prevalence of PCSL and post-traumatic stress disorder (PTSD) three months after the ER visit. One hundred and thirty patients with a high risk of PCLS were randomized. No logistic problem or patient refusal was observed. In the EMDR, reassurance and control groups, proportions of patients with PCLS at three months were 18%, 37% and 65% and those with PTSD were 3%, 16% and 19% respectively. The risk ratio for PCLS adjusted for the type of event (injury, non-injury) for the comparison between EMDR and control was 0.36 [95% CI 0.20-0.66]. This is the first randomized controlled trial that shows that a short EMDR intervention is feasible and potentially effective in the context of the ER. The study was registered at ClinicalTrials.gov (NCT03194386).
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Affiliation(s)
- Cédric Gil-Jardiné
- University Hospital of Bordeaux, Pole of Emergency Medicine, F-33000, Bordeaux, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France.
| | - Grégoire Evrard
- University Hospital of Bordeaux, Pole of Emergency Medicine, F-33000, Bordeaux, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Samantha Al Joboory
- CASPERTT, Hospital Center of Cadillac, 31 Rue des Cavaillès, F-33310 Lormont, France
| | | | - Françoise Masson
- INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France; University Hospital of Bordeaux, Pole of Anesthesia and Intensive Care, F-33000, Bordeaux, France
| | - Régis Ribéreau-Gayon
- INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France; University Hospital of Bordeaux, Pole of Medicine, F-33000, Bordeaux, France
| | - Michel Galinski
- University Hospital of Bordeaux, Pole of Emergency Medicine, F-33000, Bordeaux, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Louis-Rachid Salmi
- INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France; University Hospital of Bordeaux, Pole of Public Health, F-33000, Bordeaux, France
| | - Philippe Revel
- University Hospital of Bordeaux, Pole of Emergency Medicine, F-33000, Bordeaux, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Cyril Alexandre Régis
- CASPERTT, Hospital Center of Cadillac, 31 Rue des Cavaillès, F-33310 Lormont, France
| | - Guillaume Valdenaire
- University Hospital of Bordeaux, Pole of Emergency Medicine, F-33000, Bordeaux, France; INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
| | - Emmanuel Lagarde
- INSERM, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, F-33076 Bordeaux Cedex, France
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Linendoll N, Saunders T, Burns R, Nyce JD, Wendell KB, Evens AM, Parsons SK. Health-related quality of life in Hodgkin lymphoma: a systematic review. Health Qual Life Outcomes 2016; 14:114. [PMID: 27473596 PMCID: PMC4966803 DOI: 10.1186/s12955-016-0515-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023] Open
Abstract
Purpose Hodgkin Lymphoma (HL) is highly curable with well-established treatment regimens; however, the impact on patient’s health-related quality of life (HRQL) from diagnosis through survivorship is unclear. This systematic review aimed to describe the available literature on HRQL in HL, assess the quality of these studies, identify gaps in the literature and recommend further areas of research. Methods Following PRISMA guidelines, we performed a systematic review to include studies assessing the HRQL in HL patients. Articles identified through database searches were screened and data extracted. Quality was evaluated using a 6-point scale, adapted from published HRQL systematic reviews. Results Sixty five articles published between 1986 and 2015 met inclusion criteria. These included 53 (82 %) cross-sectional studies; 12 (18 %) longitudinal studies, including three embedded in randomized trials; and three additional longitudinal studies that began assessment at diagnosis. Study sample sizes of HL patients varied considerably with only five (42 %) longitudinal studies including more than 50 patients. Multidimensional HRQL was assessed in 45 studies, single HRQL domains in 22 studies, and symptoms, including fatigue, in 28 studies. Conclusions The majority of studies employed a cross-sectional design, enrolling HL survivors at least 10 years after the completion of therapy. Emphasis on HRQL following therapy may inform initial treatment decisions and long-term survivorship goals. We recommend that future research include prospective, longitudinal randomized designs across both treatment and time.
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Affiliation(s)
- Nadine Linendoll
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA. .,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA.
| | - Tully Saunders
- Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA
| | - Rebecca Burns
- Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA
| | - Jonathan D Nyce
- Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
| | - Kristen B Wendell
- Advocate Lutheran General Hospital, 1775 Dempster St, Park Ridge, IL, 60068, USA
| | - Andrew M Evens
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
| | - Susan K Parsons
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.,Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA.,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
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Mountifield R, Bampton P, Prosser R, Mikocka-Walus A, Andrews JM. Colon cancer surveillance in inflammatory bowel disease: unclear gain but no psychological pain? Intern Med J 2014; 44:131-8. [DOI: 10.1111/imj.12317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/29/2013] [Indexed: 12/21/2022]
Affiliation(s)
- R. Mountifield
- Flinders University of South Australia; Adelaide South Australia Australia
- Department of Gastroenterology; Flinders Medical Centre; Adelaide South Australia Australia
| | - P. Bampton
- Flinders University of South Australia; Adelaide South Australia Australia
- Department of Gastroenterology; Flinders Medical Centre; Adelaide South Australia Australia
| | - R. Prosser
- Department of Gastroenterology; Flinders Medical Centre; Adelaide South Australia Australia
| | - A. Mikocka-Walus
- School of Nursing and Midwifery; University of South Australia; Adelaide South Australia Australia
| | - J. M. Andrews
- Flinders University of South Australia; Adelaide South Australia Australia
- IBD Service; Department of Gastroenterology and Hepatology; Royal Adelaide Hospital; Adelaide South Australia Australia
- University of Adelaide; Adelaide South Australia Australia
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Breast cancer surveillance in patients treated by radiotherapy for Hodgkin's lymphoma. LA RADIOLOGIA MEDICA 2012; 118:401-14. [PMID: 22872454 DOI: 10.1007/s11547-012-0862-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 09/26/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE The authors evaluated the relative risk of developing radiation-induced breast cancer (BC) in women treated with radiotherapy for Hodgkin's disease (HD) and analysed the imaging features of these breast neoplasms. MATERIALS AND METHODS We retrospectively studied 54 women who had all undergone radiotherapy between 1980 and 2010 (median age, 36.6 years). Women aged ≤30 years were screened with clinical breast examination, ultrasound (US) and, if necessary, mammography; women >30 years had clinical breast examination, US and mammography. Three women underwent magnetic resonance (MR) imaging as well. RESULTS Mammography detected seven invasive breast cancers in 6/54 women (11.1%). Median age at diagnosis was 26.1 years for HD and 42.4 for breast cancer. Breast cancer was diagnosed following a median latent period from radiotherapy of 15.1 years. Mean radiation dose was 37.6 Gy in women who developed breast cancer and 31.3 Gy in the other women. CONCLUSIONS In our study, women who were exposed to radiation for HD had a 6.2-fold higher risk of developing breast cancer than the general population. In consideration of the young age and high breast density, women aged ≤30 years should be monitored by US and MR imaging; women aged >30 years should be monitored by US, mammography and, when necessary, MR imaging.
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Oeffinger KC, Ford JS, Moskowitz CS, Diller LR, Hudson MM, Chou JF, Smith SM, Mertens AC, Henderson TO, Friedman DL, Leisenring WM, Robison LL. Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA 2009; 301:404-14. [PMID: 19176442 PMCID: PMC2676434 DOI: 10.1001/jama.2008.1039] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
CONTEXT Women treated with chest radiation for a pediatric malignancy have a significantly increased risk of breast cancer at a young age and are recommended to have an annual screening mammogram starting at age 25 years or 8 years after radiation, whichever occurs last. OBJECTIVE To characterize the breast cancer surveillance practices among female pediatric cancer survivors who were treated with chest radiation and identify correlates of screening. DESIGN, SETTING, AND PARTICIPANTS Between June 2005 and August 2006, a 114-item questionnaire was administered to a random sample of 625 women aged 25 through 50 years who had survived pediatric cancer, who had been treated with chest radiation, and who were participating in the Childhood Cancer Survivor Study (CCSS), a North American cohort of long-term survivors diagnosed from 1970-1986. Comparisons were made with similarly aged pediatric cancer survivors not treated with chest radiation (n = 639) and the CCSS siblings cohort (n = 712). MAIN OUTCOME MEASURE Screening mammogram within the previous 2 years. RESULTS Of 1976 cancer survivors and siblings who were contacted, 87.9% participated. Among the 551 women with a history of chest radiation, 55% reported a screening mammogram in the past 2 years (ages 25-39 years, 36.5%; 95% confidence interval [CI], 31.0%-42.0%; ages 40-50 years, 76.5%; 95% CI, 71.3%-81.7%). In comparison, 40.5% of survivors without chest radiation and 37.0% of CCSS siblings reported a screening mammogram in the same time interval. Notably, among women with a history of chest radiation, 47.3% (95% CI; 41.6%-53.0%) of those younger than 40 years had never had a mammogram and only 52.6% (95% CI; 46.4%-58.8%) of women aged 40 through 50 years were being regularly screened (2 mammograms within 4 years). Screening rates were higher among women who reported a physician recommendation than those who did not (ages 25-39 years, 76.0% vs 17.6%; ages 40-50 years, 87.3% vs 58.3%). In multivariate models, the association was particularly strong for younger women (ages 25-39 years, prevalence ratio [PR], 3.0; 95% CI, 2.0-4.0; ages 40-50 years, PR, 1.3; 95% CI, 1.1-1.6). CONCLUSIONS In this cohort of women who had childhood cancer treated with chest radiation, 63.5% of those aged 25 through 39 years and 23.5% of those aged 40 through 50 years had not had mammography screening for breast cancer within the previous 2 years despite a guideline recommendation that survivors of childhood cancer who were treated with chest radiation should undergo annual screening mammography.
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Affiliation(s)
- Kevin C Oeffinger
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.
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