1
|
Richards HS, Portal A, Absolom K, Blazeby JM, Velikova G, Avery KNL. Patient experiences of an electronic PRO tailored feedback system for symptom management following upper gastrointestinal cancer surgery. Qual Life Res 2020; 30:3229-3239. [PMID: 32535864 PMCID: PMC8528794 DOI: 10.1007/s11136-020-02539-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 11/26/2022]
Abstract
Purpose Complications following upper gastrointestinal (UGI) surgery are common. Symptom-monitoring following discharge is not standardized. An electronic patient-reported outcome (ePRO) system providing feedback to patients and clinicians could support patients and improve outcomes. Little is known about patients’ experiences of using such systems. This qualitative sub-study explored patients’ perspectives of the benefits of using a novel ePRO system, developed as part of the mixed methods eRAPID pilot study, to support recovery following discharge after UGI surgery. Methods Patients completed the online ePRO symptom-report system post-discharge. Weekly interviews explored patients’ experiences of using ePRO, the acceptability of feedback generated and its value for supporting their recovery. Interviews were audio-recorded and targeted transcriptions were thematically analysed. Results Thirty-five interviews with 16 participants (11 men, mean age 63 years) were analysed. Two main themes were identified: (1) reassurance and (2) empowerment. Feelings of isolation were common; many patients felt uninformed regarding their expectations of recovery and whether their symptoms warranted clinical investigation. Participants were reassured by tailored feedback advising them to contact their care team, alleviating their anxiety. Patients reported feeling empowered by the ePRO system and in control of their symptoms and recovery. Conclusion Patients recovering at home following major cancer surgery regarded electronic symptom-monitoring and feedback as acceptable and beneficial. Patients perceived that the system enhanced information provision and provided a direct link to their care team. Patients felt that the system provided reassurance at a time of uncertainty and isolation, enabling them to feel in control of their symptoms and recovery. Electronic supplementary material The online version of this article (10.1007/s11136-020-02539-w) contains supplementary material, which is available to authorised users.
Collapse
Affiliation(s)
- H S Richards
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - A Portal
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - K Absolom
- Leeds Institute of Medical Research at St James, St James's Hospital, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - J M Blazeby
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James, St James's Hospital, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - K N L Avery
- Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Medical School: Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
2
|
Richards HS, Blazeby JM, Portal A, Harding R, Reed T, Lander T, Chalmers KA, Carter R, Singhal R, Absolom K, Velikova G, Avery KNL. A real-time electronic symptom monitoring system for patients after discharge following surgery: a pilot study in cancer-related surgery. BMC Cancer 2020; 20:543. [PMID: 32522163 PMCID: PMC7285449 DOI: 10.1186/s12885-020-07027-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background Advances in peri-operative care of surgical oncology patients result in shorter hospital stays. Earlier discharge may bring benefits, but complications can occur while patients are recovering at home. Electronic patient-reported outcome (ePRO) systems may enhance remote, real-time symptom monitoring and detection of complications after hospital discharge, thereby improving patient safety and outcomes. Evidence of the effectiveness of ePRO systems in surgical oncology is lacking. This pilot study evaluated the feasibility of a real-time electronic symptom monitoring system for patients after discharge following cancer-related upper gastrointestinal surgery. Methods A pilot study in two UK hospitals included patients who had undergone cancer-related upper gastrointestinal surgery. Participants completed the ePRO symptom-report at discharge, twice in the first week and weekly post-discharge. Symptom-report completeness, system actions, barriers to using the ePRO system and technical performance were examined. The ePRO surgery system is an online symptom-report that allows clinicians to view patient symptom-reports within hospital electronic health records and was developed as part of the eRAPID project. Clinically derived algorithms provide patients with tailored self-management advice, prompts to contact a clinician or automated clinician alerts depending on symptom severity. Interviews with participants and clinicians determined the acceptability of the ePRO system to support patients and their clinical management during recovery. Results Ninety-one patients were approached, of which 40 consented to participate (27 male, mean age 64 years). Symptom-report response rates were high (range 63–100%). Of 197 ePRO completions analysed, 76 (39%) triggered self-management advice, 72 (36%) trigged advice to contact a clinician, 9 (5%) triggered a clinician alert and 40 (20%) did not require advice. Participants found the ePRO system reassuring, providing timely information and advice relevant to supporting their recovery. Clinicians regarded the system as a useful adjunct to usual care, by signposting patients to seek appropriate help and enhancing their understanding of patients’ experiences during recovery. Conclusion Use of the ePRO system for the real-time, remote monitoring of symptoms in patients recovering from cancer-related upper gastrointestinal surgery is feasible and acceptable. A definitive randomised controlled trial is needed to evaluate the impact of the system on patients’ wellbeing after hospital discharge.
Collapse
Affiliation(s)
- H S Richards
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - J M Blazeby
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.,Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - A Portal
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - R Harding
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - T Reed
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - T Lander
- Division of Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - K A Chalmers
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - R Carter
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - R Singhal
- Queen Elizabeth Hospital Birmingham, Mindelson Way, Edgbaston, Birmingham, B15 2WB, UK
| | - K Absolom
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - G Velikova
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James's, University of Leeds, St James's Hospital, Leeds, LS9 7TF, UK
| | - K N L Avery
- Medical Research Council ConDuCT-II Hub for Trials Methodology Research, National Institute for Health Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK
| |
Collapse
|
3
|
Baba-Hamed N, Portal A. [Canal anal carcinoma]. Rev Prat 2019; 69:311-317. [PMID: 30983261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Canal anal carcinoma. Anal carcinomas are rare, but their incidence has increased in recent years. They are induced by the Human papillomas virus (mostly genotype 16). The prevalence is high among HIV-infected men who have sex with men (MSM) and primary prevention by vaccination against HPV is a source of hope in this population. Screening is based on the detection and treatment of precancerous lesions, called anal intra-epithelial neoplasia, which can be of low grade or high grade. It concerns a category of HIV-infected patients: MSM, history of condyloma or precancerous/cancerous lesions of the cervix. Treatment, based on a combination of simultaneous chemotherapy and radiation therapy, allows a complete response rate of 80%. In case of persistence or tumor recurrence, abdominoperineal resection remains the treatment of choice. Advanced diseases can benefit from highly effective chemotherapy combinations or even in the future, combination of chemotherapy and immunotherapy.
Collapse
Affiliation(s)
- Nabil Baba-Hamed
- Service d'oncologie, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - Alix Portal
- Service de proctologie, groupe hospitalier Paris Saint-Joseph, Paris, France
| |
Collapse
|
4
|
Avery K, Richards H, Portal A, Reed T, Harding R, Carter R, Absolom K, Velikova G, Blazeby J. Systematic electronic capture of patient reported outcomes after cancer surgery: A valuable adjunct to post-operative care. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
5
|
Pernot S, Bachet JB, Portal A, Taieb J. Reply to the comment on 'Nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma after Folfirinox failure: an AGEO prospective multicentre cohort'. Br J Cancer 2016; 114:e9. [PMID: 27124338 PMCID: PMC4891508 DOI: 10.1038/bjc.2016.70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Simon Pernot
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris 75015, France
| | - Jean-Baptiste Bachet
- Department of Gastroenterology, La Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, UPMC University, Paris 75013, France
| | - Alix Portal
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris 75015, France
| | - Julien Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris 75015, France
| |
Collapse
|
6
|
Portal A, Pernot S, Tougeron D, Arbaud C, Bidault AT, de la Fouchardière C, Hammel P, Lecomte T, Dréanic J, Coriat R, Bachet JB, Dubreuil O, Marthey L, Dahan L, Tchoundjeu B, Locher C, Lepère C, Bonnetain F, Taieb J. Nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma after Folfirinox failure: an AGEO prospective multicentre cohort. Br J Cancer 2015; 113:989-95. [PMID: 26372701 PMCID: PMC4651133 DOI: 10.1038/bjc.2015.328] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/07/2015] [Accepted: 08/13/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is currently no standard second-line treatment for metastatic pancreatic adenocarcinoma (MPA), and progression-free survival is consistently <4 months in this setting. The aim of this study was to evaluate the efficacy and tolerability of Nab-paclitaxel plus gemcitabine (A+G) after Folfirinox failure in MPA. METHODS From February 2013 to July 2014, all consecutive patients treated with A+G for histologically proven MPA after Folfirinox failure were prospectively enrolled in 12 French centres. A+G was delivered as described in the MPACT trial, until disease progression, patient refusal or unacceptable toxicity. RESULTS Fifty-seven patients were treated with Nab-paclitaxel plus gemcitabine, for a median of 4 cycles (range 1-12). The disease control rate was 58%, with a 17.5% objective response rate. Median overall survival (OS) was 8.8 months (95% CI: 6.2-9.7) and median progression-free survival was 5.1 months (95% CI: 3.2-6.2). Since the start of first-line chemotherapy, median OS was 18 months (95% CI: 16-21). No toxic deaths occurred. Grade 3-4 toxicities were reported in 40% of patients, consisting of neutropenia (12.5%), neurotoxicity (12.5%), asthenia (9%) and thrombocytopenia (6.5%). CONCLUSIONS A+G seems to be effective, with a manageable toxicity profile, after Folfirinox failure in patients with MPA.
Collapse
Affiliation(s)
- Alix Portal
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France
| | - Simon Pernot
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France
| | - David Tougeron
- Department of Gastroenterology, Poitiers University Hospital, Poitiers, France
| | - Claire Arbaud
- Methodological and Quality of Life Unit in Oncology, Quality of Life and Cancer Clinical Research Platform, Besançon University Hospital, Besançon, France
| | - Anne Thirot Bidault
- Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France
| | | | - Pascal Hammel
- Department of Digestive Oncology, Hospital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Denis Diderot University, Clichy, France
| | - Thierry Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital of Tours, UMR CNRS 7192, François-Rabelais University, Tours, France
| | - Johann Dréanic
- Gastroenterology and Endoscopy Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Romain Coriat
- Gastroenterology and Endoscopy Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Jean-Baptiste Bachet
- Department of Gastroenterology, La Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, UPMC University Paris 06, Paris, France
| | - Olivier Dubreuil
- Department of Gastroenterology, La Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, UPMC University Paris 06, Paris, France
| | - Lysiane Marthey
- Department of Hepatogastroenterology and Nutrition, Antoine-Béclère Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), DHU Hepatinov, Clamart, France
| | - Laetitia Dahan
- Department of Gastroenterology, University Hospital La Timone, Aix-Marseille University, Marseille, France
| | - Belinda Tchoundjeu
- Department of Gastroenterology and Digestive Oncology, Orleans Regional Hospital (CHRO), Orleans, France
| | | | - Céline Lepère
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France
| | - Franck Bonnetain
- Methodological and Quality of Life Unit in Oncology, Quality of Life and Cancer Clinical Research Platform, Besançon University Hospital, Besançon, France
| | - Julien Taieb
- Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France
| |
Collapse
|
7
|
Portal A, Pernot S, Arbaud C, Tougeron D, Thirot-Bidault A, De La Fouchardiere C, Hammel P, Lecomte T, Dreanic J, Coriat R, Bachet JB, Dubreuil O, Marthey L, Dahan L, Legoux JL, Locher C, Lepère C, Rougier P, Bonnetain F, Taieb J. Nab paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma after failure of folfirinox: Results of an AGEO multicenter prospective cohort. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.4123] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alix Portal
- Hopital Européen Georges Pompidou, Paris, France
| | - Simon Pernot
- Paris Descartes University, Georges Pompidou European Hospital, Paris, France
| | - Claire Arbaud
- Methodology and Quality of Life in Oncology Unit and Quality of Life and Cancer Clinical Research Platform, Besançon, France
| | - David Tougeron
- Medical Oncology Department, Poitiers University Hospital, Poitiers, France
| | - Anne Thirot-Bidault
- Department of Hepato-Gastroenterology, Bicêtre Hospital, Kremlin-Bicêtre, France
| | | | | | | | | | - Romain Coriat
- Unité D'oncologie Médicale, St. Jacques, Paris, France
| | | | - Olivier Dubreuil
- Centre Hospitalier Universitaire Pitié Salpétrière, Paris, France
| | | | - Laetitia Dahan
- La Timone, Marseille University Hospital, Marseille, France
| | | | - Christophe Locher
- Department of Hepato-Gastroenterology, Meaux Hospital, Meaux, France
| | | | - Philippe Rougier
- Paris Descartes University, Georges Pompidou European Hospital, Paris, France
| | - Franck Bonnetain
- Centre Hospitalier Régional et Universitaire de Besançon, Besançon, France
| | - Julien Taieb
- Paris Descartes University, Georges Pompidou European Hospital, Paris, France
| |
Collapse
|
8
|
Portal A, Pernot S, Siauve N, Landi B, Lepère C, Colussi O, Rougier P, Zaanan A, Verrière B, Taieb J. Sustained response with gemcitabine plus Nab-paclitaxel after folfirinox failure in metastatic pancreatic cancer: report of an effective new strategy. Clin Res Hepatol Gastroenterol 2014; 38:e23-6. [PMID: 24559766 DOI: 10.1016/j.clinre.2014.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 01/10/2014] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Folfirinox has shown a benefit in terms of survival and quality of life in first line treatment of metastatic pancreatic cancer. However, efficacy of second line chemotherapy after folfirinox is still limited. Gemcitabine plus Nab-paclitaxel have been recently validated as first line treatment with an increased overall survival compared to gemcitabine. This combination has never been studied as second-line after folfirinox. CASE REPORT A metastatic pancreatic cancer was diagnosed in a 60-year-old patient with a performance status of 0. After 10 cycles of folfirinox, and an initial objective response, we objectively noted progressive disease according to the RECIST 1.1 criteria together with an increased carbohydrate antigen 19-9. The multidisciplinary team decided to use gemcitabine plus Nab-paclitaxel as second line palliative chemotherapy. After 2 months, we obtained an objective response. After 6 months, this response was maintained with an acceptable tolerability. CONCLUSION Gemcitabine plus Nab-paclitaxel, as second line palliative chemotherapy, after failure of folfirinox, could be a good strategy for patients with a performance status of 0 and 1. Obviously, this data has to be confirmed in larger patients series and in future comparative clinical studies.
Collapse
Affiliation(s)
- Alix Portal
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Simon Pernot
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Nathalie Siauve
- Service de radiologie, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, Paris, France
| | - Bruno Landi
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Céline Lepère
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Orianne Colussi
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Philippe Rougier
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Aziz Zaanan
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
| | - Benjamin Verrière
- Service de pharmacie, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, Paris, France
| | - Julien Taieb
- Service d'hépatogastro-entérologie et d'oncologie digestive, université Paris Descartes, Sorbonne Paris-Cité, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
| |
Collapse
|
9
|
Mayuet P, Gallo A, Portal A, Arroyo P, Alvarez M, Marcos M. Damaged Area based Study of the Break-IN and Break-OUT Defects in the Dry Drilling of Carbon Fiber Reinforced Plastics (CFRP). ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.proeng.2013.08.249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
Portal A, Austin M, Bruce M, Sizer E, Auzinger G, Heneghan M, Wendon J. A comparison of Gc globulin and neutrophil gelatinase-associated lipocalin in patients with liver disease. Crit Care 2007. [PMCID: PMC4095447 DOI: 10.1186/cc5554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
11
|
Austin M, Portal A, Wendon J. What is the role of carboxyhaemoglobin in patients with liver failure? Crit Care 2007. [PMCID: PMC4095450 DOI: 10.1186/cc5557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
12
|
Campos A, Vaz CP, Campilho F, Morais A, Guimarães MA, Lopes C, Portal A, Carvalhais A, Pimentel P. Central nervous system (CNS) tuberculosis following allogeneic stem cell transplantation. Bone Marrow Transplant 2000; 25:567-9. [PMID: 10713637 DOI: 10.1038/sj.bmt.1702163] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Tuberculosis is an uncommon infectious complication after stem cell transplantation. We report a patient who presented with a brain mass, 3 months after pulmonary tuberculosis had been diagnosed and while he was receiving triple antituberculous therapy. He had extensive chronic GVHD. The diagnosis was made after biopsy of the lesion. The cerebral mass was excised, antituberculous treatment was maintained and the patient made a complete neurologic recovery. Six months later, he died of gram-negative septic shock. Mycobacterial infections should be considered in allograft recipients with chronic GVHD and solid lesions in the brain. Bone Marrow Transplantation (2000) 25, 567-569.
Collapse
Affiliation(s)
- A Campos
- Bone Marrow Transplant Unit, Instituto Português de Oncologia, Porto, Portugal
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Rodrigues N, Bastos Z, Veloso J, Portal A. The assessment and treatment of intractable pain in uterine cancer. Pain 1984. [DOI: 10.1016/0304-3959(84)90456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Portal A, Duron F, Aubert P. [Therapeutics future of liposomes (author's transl)]. Nouv Presse Med 1979; 8:1749-52. [PMID: 286979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The possibility to use the liposomes as drug vehicles has been largely investigated in recent years. Most of the studies have been carried out in animals and are related to disease involving predominantly the reticulohistiocytic system. Attempts to use these liposomes orally (induced diabetes) or locally (induced arthritis) are also reported. Further trials are required to get a better knowledge of the mechanisms involved in the exchanges between the cell membrane and the liposome the latter being variable as regards its composition, size and permeability according to the various investigators; the adjustment to the liposome of a complex capable to electively direct it towards the target organ is studied.
Collapse
|
15
|
Portal A, Gaillot J, Bieder A, Rodary C, Bertharion JJ. [Aspects of the physiologic bioavailability of spironolactone and canrenone]. Sem Hop Ther 1976; 52:465-70. [PMID: 1006321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
16
|
Duron F, Pointillard J, Françon J, Portal A, Acar J, Lainée J, Aubert P. [Progressive polyserositis complicating a case of biologically stabilized rheumatoid arthritis. Constrictive pericarditis treated by pericardectomy]. Ann Med Interne (Paris) 1976; 127:837-42. [PMID: 1015717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
17
|
Masbernard A, Lainée J, Laurens A, Portal A, Giudicelli C, Lombard C, D'Audibert F, Bourguet CD. [Nephrotoxicity of cephalotin-gentamycin association. Clinical study of 4 cases]. Ann Med Interne (Paris) 1974; 125:749-54. [PMID: 4451306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
18
|
Portal A. [Does quinine still have its place in malaria therapy?]. Sem Hop Ther 1973; 49:47-9. [PMID: 4712025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
19
|
Masbernard A, Portal A. [The real problem in diabetes (trial of gliclazide, an original molecule with metabolic and vascular properties)]. Therapeutique 1972; 48:569-73. [PMID: 4650526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
20
|
Aubert P, Portal A, Bernuau J, Lainée J. [Diabetes insipidus and anterior pituitary gland insufficiency]. Ann Med Interne (Paris) 1972; 123:421-4. [PMID: 5077049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
21
|
Portal A, Poujol J, Laverdant C, Lombard J, Ille H, Hardelin J. [Severe forms of malaria in France]. Ann Med Interne (Paris) 1971; 122:397-403. [PMID: 4933592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
22
|
Alric R, Portal A. [Quantitative pharmacodynamics with an endocrine cell: sulfonylureas and insulin secretion]. Therapie 1969; 24:871-80. [PMID: 5364207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
23
|
Fromantin M, Portal A, Essioux H. [Circumstances of detection and etiologic factors of diabetes mellitus in a military milieu. 500 cases]. Rev Corps Sante Armees Terre Mer Air 1969; 10:15-30. [PMID: 4249746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
24
|
Pernod J, Servelle M, Portal A, Kermarec J. [Low thoracic coarctations (apropos of a case treated surgically by by-pass)]. Arch Mal Coeur Vaiss 1967; 60:1202-13. [PMID: 4964913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
25
|
Memin Y, Portal A, Larribaud J, Duriez R, Bensaude A. [Role of an anti-infective mucilage in the stages of treatment with bismuth]. Sem Ther 1966; 42:499-501. [PMID: 5988520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
26
|
Portal A, Attias J. [Kinetics of hydrolysis of phosphorylcholine in a very acid medium]. C R Acad Hebd Seances Acad Sci D 1965; 260:7041-4. [PMID: 4954019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
27
|
Portal A, Castellan M. [Meta-amebic colopathies. Excellence of subnitrate of heavy bismuth]. Sem Ther 1964; 40:21-3. [PMID: 5878905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|