1
|
L’Her E, Geeraerts T, Desclefs JP, Benhamou D, Blanie A, Cerf C, Delmas V, Jourdain M, Lecomte F, Ouanes I, Garnier M, Mossadegh C. Recommandations de pratiques professionnelles : Intérêts de l’apprentissage par simulation en soins critiques. Ann Fr Med Urgence 2022. [DOI: 10.3166/afmu-2022-0411] [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: 11/20/2022]
|
2
|
Guillemot P, Lecomte F, Camsonne-Pioline N, Cohen-Bittan J, Martinez-Caballero M, Boddaert J, Meziere A. Impact de la dénutrition mesurée par l’IMC sur la récupération de la marche après fracture de l’extrémité supérieure du fémur en SSR orthogériatrique. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.086] [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: 10/18/2022]
|
3
|
Lecomte F, Martinez-Caballero M, Camsonne-Pioline N, Cohen-Bittan J, Boddaert J, Meziere A. Impact de la carence en vitamine D sur la récupération fonctionnelle après fracture du col du fémur chez les patients âgés hospitalisés en soins de suite et réadaptation orthogériatrique. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.087] [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: 11/17/2022]
|
4
|
Leroy HA, Guérin L, Lecomte F, Baert G, Vignion AS, Mordon S, Reyns N. Is interstitial photodynamic therapy for brain tumors ready for clinical practice? A systematic review. Photodiagnosis Photodyn Ther 2021; 36:102492. [PMID: 34419674 DOI: 10.1016/j.pdpdt.2021.102492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Interstitial photodynamic therapy (iPDT), inserting optical fibers inside brain tumors, has been proposed for more than 30 years. While a promising therapeutic option, it is still an experimental treatment, with different ways of application, depending on the team performing the technique. OBJECTIVE In this systematic review, we reported the patient selection process, the treatment parameters, the potential adverse events and the oncological outcomes related to iPDT treatment applied to brain tumors. METHODS We performed a search in PubMed, Embase and Medline based on the following Mesh terms: "interstitial" AND "photodynamic therapy" AND "brain tumor" OR "glioma" OR glioblastoma" from January 1990 to April 2020. We screened 350 studies. Twelve matched all selection criteria. RESULTS 251 patients underwent iPDT. Tumors were mainly de novo or recurrent high-grade gliomas (171 (68%) of glioblastomas), located supratentorial, with a median volume of 12 cm3. Hematoporphyrin derive agent (HpD) or protoporphyrin IX (PpIX) induced by 5-aminolevulinic acid (5-ALA) was used as a photosensitizer. Up to 6 optical fibers were introduced inside the tumor, delivering 200 mW/cm at a wavelength of 630 nm. Overall mortality was 1%. Transient and persistent morbidity were both 5%. No permanent deficit occurred using 5-ALA PDT. Tumor response rate after iPDT was 92% (IQR, 67; 99). Regarding glioblastomas, progression-free-survival was respectively 14.5 months (IQR, 13.8; 15.3) for de novo lesions and 14 months (IQR, 7; 30) for recurrent lesions, while overall survival was respectively 19 months (IQR, 14; 20) and 8 months (IQR, 6.3; 8.5). In patients harboring high-grade gliomas, 33 (13%) were considered long-term survivors (> 2 years) after iPDT. CONCLUSION Regardless of heterogeneity in its application, iPDT appears safe and efficient to treat brain tumors, especially high-grade gliomas. Stand-alone iPDT (i.e., without combined craniotomy and intracavitary PDT) using 5-ALA appears to be the best option in terms of controlling side effects: it avoids the occurrence of permanent neurological deficits while reducing the risks of hemorrhage and sepsis.
Collapse
Affiliation(s)
- Henri-Arthur Leroy
- CHU Lille, Department of Neurosurgery, F-59000 Lille, France; INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France.
| | - Laura Guérin
- INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| | - Fabienne Lecomte
- INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| | - Grégory Baert
- INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| | - Anne-Sophie Vignion
- INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| | - Serge Mordon
- INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| | - Nicolas Reyns
- CHU Lille, Department of Neurosurgery, F-59000 Lille, France; INSERM, CHU-Lille, U1189-ONCOTHAI-Assisted Laser Therapy and Immunotherapy for Oncology, Univ-Lille, F-59000 Lille, France
| |
Collapse
|
5
|
Lecomte F, Thecua E, Ziane L, Deleporte P, Duhamel A, Vamour C, Mordon S, Rakza T. Phototherapy Using a Light-Emitting Fabric (BUBOLight) Device in the Treatment of Newborn Jaundice: Protocol for an Interventional Feasibility and Safety Study. JMIR Res Protoc 2021; 10:e24808. [PMID: 34032584 PMCID: PMC8188309 DOI: 10.2196/24808] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Neonatal jaundice is a common condition occurring in 60%-80% of all healthy-term and late-preterm neonates. In the majority of cases, neonatal jaundice resolves spontaneously and causes no harm; however, in some neonates, significant hyperbilirubinemia can develop and lead to kernicterus jaundice, a serious neurological disease. Phototherapy (PT) is the preferred treatment for jaundice; however, to be effective, PT devices need to have a broad light emission surface to generate no or little heat and to provide an optimal wavelength and light intensity (420-490 nm and ≥30 µW/cm²/nm, respectively). Objective This study aimed to investigate the feasibility, safety, and level of satisfaction of parents and health care teams with the BUBOlight device, an innovative alternative to conventional hospital PT, in which luminous textiles have been incorporated in a sleeping bag. Methods This interventional, exploratory, simple group, nonrandomized, single-center trial will be conducted at Lille Hospital. In total, 10-15 neonates and their parents will be included to obtain evaluable data from 10 parent-neonate pairs. Neonates weighing more than 2500 g at birth and born with ≥37 weeks of amenorrhea that required PT in accordance with the guidelines of the National Institute For Health and Clinical Excellence will receive one 4-hour session of illumination. Total serum bilirubin and transcutaneous bilirubin levels were obtained at the start and 2 hours after the end of PT. Cutaneous and rectal temperatures, heart rate, and oxygen saturation will be measured at the beginning and during PT. The number of subjects is therefore not calculated on the basis of statistical assumptions. We aim to obtain a minimum proportion of 90% (ie, 9 of 10) of the neonates included, who have been able to undergo 4-hour PT without unacceptable and unexpected toxicities. We will calculate the mean, median, quartiles, minimum and maximum values of the quantitative parameters, and the frequency of the qualitative parameters. The rate of patients with no unacceptable and unexpected toxicities (ie, the primary endpoint) will be calculated. Results The first patient is expected to be enrolled at the end of 2020, and clinical investigations are intended for up to June 2021. The final results of this study are expected to be available at the end of 2021. Conclusions Our findings will provide insights into the safety and feasibility of a new PT device based on light-emitting fabrics for the treatment of newborn jaundice. This new system, if proven effective, will improve the humanization of neonatal care and help avoid mother-child separation. Trial Registration ClinicalTrials.gov NCT04365998; https://clinicaltrials.gov/ct2/show/NCT04365998 International Registered Report Identifier (IRRID) PRR1-10.2196/24808
Collapse
Affiliation(s)
- Fabienne Lecomte
- U1189 - Assisted Laser Therapy and Immunotherapy for Oncology, Univ- Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Elise Thecua
- U1189 - Assisted Laser Therapy and Immunotherapy for Oncology, Univ- Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Laurine Ziane
- U1189 - Assisted Laser Therapy and Immunotherapy for Oncology, Univ- Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Pascal Deleporte
- U1189 - Assisted Laser Therapy and Immunotherapy for Oncology, Univ- Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Alain Duhamel
- EA 2694 - Santé publique: épidémiologie et qualité des soins, Univ- Lille, CHU Lille, F-59000 Lille, France
| | - Clémence Vamour
- Jeanne de Flandre Hospital, Department of Obstetrics, CHU Lille, F-59000 Lille, France
| | - Serge Mordon
- U1189 - Assisted Laser Therapy and Immunotherapy for Oncology, Univ- Lille, Inserm, CHU Lille, F-59000 Lille, France
| | - Thameur Rakza
- EA4489, Perinatal Growth and Health, Jeanne de Flandre Hospital, Department of Obstetrics, Univ- Lille, CHU Lille, F-59000 Lille, France
| |
Collapse
|
6
|
Vermandel M, Dupont C, Lecomte F, Leroy HA, Tuleasca C, Mordon S, Hadjipanayis CG, Reyns N. Standardized intraoperative 5-ALA photodynamic therapy for newly diagnosed glioblastoma patients: a preliminary analysis of the INDYGO clinical trial. J Neurooncol 2021; 152:501-514. [PMID: 33743128 DOI: 10.1007/s11060-021-03718-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/13/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Glioblastoma (GBM) is the most aggressive malignant primary brain tumor. The unfavorable prognosis despite maximal therapy relates to high propensity for recurrence. Thus, overall survival (OS) is quite limited and local failure remains the fundamental problem. Here, we present a safety and feasibility trial after treating GBM intraoperatively by photodynamic therapy (PDT) after 5-aminolevulinic acid (5-ALA) administration and maximal resection. METHODS Ten patients with newly diagnosed GBM were enrolled and treated between May 2017 and June 2018. The standardized therapeutic approach included maximal resection (near total or gross total tumor resection (GTR)) guided by 5-ALA fluorescence-guided surgery (FGS), followed by intraoperative PDT. Postoperatively, patients underwent adjuvant therapy (Stupp protocol). Follow-up included clinical examinations and brain MR imaging was performed every 3 months until tumor progression and/or death. RESULTS There were no unacceptable or unexpected toxicities or serious adverse effects. At the time of the interim analysis, the actuarial 12-months progression-free survival (PFS) rate was 60% (median 17.1 months), and the actuarial 12-months OS rate was 80% (median 23.1 months). CONCLUSIONS This trial assessed the feasibility and the safety of intraoperative 5-ALA PDT as a novel approach for treating GBM after maximal tumor resection. The current standard of care remains microsurgical resection whenever feasible, followed by adjuvant therapy (Stupp protocol). We postulate that PDT delivered immediately after resection as an add-on therapy of this primary brain cancer is safe and may help to decrease the recurrence risk by targeting residual tumor cells in the resection cavity. Trial registration NCT number: NCT03048240. EudraCT number: 2016-002706-39.
Collapse
Affiliation(s)
- Maximilien Vermandel
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France
- Neurosurgery Department, CHU Lille, 59000, Lille, France
| | - Clément Dupont
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France
| | - Fabienne Lecomte
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France
| | - Henri-Arthur Leroy
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France
- Neurosurgery Department, CHU Lille, 59000, Lille, France
| | - Constantin Tuleasca
- Faculty of Biology and Medicine (FBM) and Centre Hospitalier Universitaire Vaudois (CHUV), Clinical Neurosciences Department, Neurosurgery Service and Gamma Knife Center, University of Lausanne (Unil), Lausanne, Switzerland
- Signal Processing Laboratory (LTS 5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Serge Mordon
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France
| | - Constantinos G Hadjipanayis
- Department of Neurosurgery, Icahn School of Medicine At Mount Sinai, Mount Sinai Health System, New York, NY, USA
- Department of Neurosurgery, Mount Sinai Beth Israel, New York, NY, USA
| | - Nicolas Reyns
- Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI -Laser Assisted Therapies and Immunotherapies for Oncology, 59000, Lille, France.
- Neurosurgery Department, CHU Lille, 59000, Lille, France.
| |
Collapse
|
7
|
Nieuwjaer N, Beydoun A, Lecomte F, Manil B, Cappelluti F, Guidoni L, Scuderi D, Desfrançois C. IRMPD spectroscopy and quantum chemistry calculations on mono- and bi-metallic complexes of acetylacetonate ligands with aluminum, iron, and ruthenium ions. J Chem Phys 2020; 153:234303. [PMID: 33353333 DOI: 10.1063/5.0031653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Metal-ligand cluster ions are structurally characterized by means of gas-phase infrared multiple photon dissociation spectroscopy. The mass-selected complexes consist of one or two metal cations M3+ (M = Al, Fe, or Ru) and two to five anionic bidentate acetylacetonate ligands. Experimental IR spectra are compared with different density functional theory calculations, namely, PBE/TZVP, B3LYP/6-31G*, and M06/6-31+G**. Frequency analysis was also performed at different levels, namely, scaled static harmonic and unscaled static anharmonic, or with ab initio molecular dynamics simulations at the PBE/TZVP level. All methods lead to simulated spectra that fit rather well with experimental data, and the spectral red shifts of several main bands, in the 1200 cm-1-1800 cm-1 range, are sensitive to the strength of the metal-ligand interaction and to the spin state of the ion. Due to the rigidity of those complexes, first principles molecular dynamics calculations provide spectra similar to that produced by static calculations that are already able to catch the main spectral signatures using harmonic calculations at the B3LYP/6-31G* level.
Collapse
Affiliation(s)
- N Nieuwjaer
- Université Sorbonne Paris Nord, Lab. de Physique des Lasers, CNRS, 93430 Villetaneuse, France
| | - A Beydoun
- Université Sorbonne Paris Nord, Lab. de Physique des Lasers, CNRS, 93430 Villetaneuse, France
| | - F Lecomte
- Université Sorbonne Paris Nord, Lab. de Physique des Lasers, CNRS, 93430 Villetaneuse, France
| | - B Manil
- Université Sorbonne Paris Nord, Lab. de Physique des Lasers, CNRS, 93430 Villetaneuse, France
| | - F Cappelluti
- University of L'Aquila, Department of Information Engineering, Computer Science and Mathematics, 67100 L'Aquila, Italy
| | - L Guidoni
- University of L'Aquila, Department of Physical and Chemical Sciences, 67100 L'Aquila, Italy
| | - D Scuderi
- Université Paris Saclay, Institut de Chimie Physique, UMR 8000 CNRS, 91400 Orsay, France
| | - C Desfrançois
- Université Sorbonne Paris Nord, Lab. de Physique des Lasers, CNRS, 93430 Villetaneuse, France
| |
Collapse
|
8
|
Le Calvé C, Abi Rached H, Vicentini C, Maire C, Lecomte F, Thecua E, Ziane L, Mordon S, Staumont-Sallé D, Mortier L. Traitement d’une maladie de Paget vulvaire (MPV) par photothérapie dynamique (PDT) à l’aide d’un nouveau dispositif textile lumineux. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.256] [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]
|
9
|
Mordon S, Thécua E, Ziane L, Lecomte F, Deleporte P, Baert G, Vignion‐Dewalle A. Light emitting fabrics for photodynamic therapy: Technology, experimental and clinical applications. Translational Biophotonics 2020. [DOI: 10.1002/tbio.202000005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Serge Mordon
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Elise Thécua
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Laurine Ziane
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Fabienne Lecomte
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Pascal Deleporte
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Grégory Baert
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| | - Anne‐Sophie Vignion‐Dewalle
- University of Lille, Inserm, CHU Lille, U1189 – OncoThAI –Laser Assisted Therapies and Immunotherapies for Oncology Lille France
| |
Collapse
|
10
|
Dupont C, Vermandel M, Leroy HA, Quidet M, Lecomte F, Delhem N, Mordon S, Reyns N. INtraoperative photoDYnamic Therapy for GliOblastomas (INDYGO): Study Protocol for a Phase I Clinical Trial. Neurosurgery 2020; 84:E414-E419. [PMID: 30053213 DOI: 10.1093/neuros/nyy324] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/17/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Glioblastoma (GBM) is characterized by marked proliferation, major infiltration, and poor prognosis. Despite current treatments, including surgery, radiation oncology, and chemotherapy, the overall median survival is 15 mo and the progression-free survival is 7 to 8 mo. Because of systematic relapse of the tumor, the improvement of local control remains an issue. In this context, photodynamic therapy (PDT) may offer a new treatment modality for GBM. OBJECTIVE To assess the feasibility of intraoperative PDT early after surgical resection of GBM without unacceptable and unexpected toxicities. METHODS The INDYGO clinical trial (INtraoperative photoDYnamic Therapy for GliOblastomas) treatment will be carried out in addition to the current standard of care (SOC) of glioblastoma: maximum resection surgery followed by concomitant radio-chemotherapy and adjuvant chemotherapy. PDT treatment will be delivered during surgery early, after the fluorescence-guided resection. Immunological responses and biomarkers will also be investigated during the follow-up. A total of 10 patients will be recruited during this study. EXPECTED OUTCOMES Clinical follow-up after the SOC with PDT is expected to be similar (no significant difference) to the SOC alone. DISCUSSION This INDYGO trial assesses the feasibility of intraoperative 5-aminolevulinic acid PDT, a novel seamless approach to treat GBM. The technology is easily embeddable within the reference treatment at a low-incremental cost. The safety of this new treatment modality is a preliminary requirement before a multicenter randomized clinical trial can be further conducted to assess local control improvement by treating infiltrating and nonresected GBM cells.
Collapse
Affiliation(s)
- Clément Dupont
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France
| | - Maximilien Vermandel
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France.,Department of Neurosurgery, University of Lille, CHU Lille, Lille, France
| | - Henri-Arthur Leroy
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France.,Department of Neurosurgery, University of Lille, CHU Lille, Lille, France
| | - Mathilde Quidet
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France.,Department of Neurosurgery, University of Lille, CHU Lille, Lille, France
| | - Fabienne Lecomte
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France
| | - Nadira Delhem
- Institut de biologie de Lille, Institut Pasteur de Lille, University of Lille, CNRS, Lille, France
| | - Serge Mordon
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France
| | - Nicolas Reyns
- University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France.,Department of Neurosurgery, University of Lille, CHU Lille, Lille, France
| |
Collapse
|
11
|
Lecomte F, Aerts J, Plenevaux A, Defraiteur C, Chapuis-Hugon F, Rozet E, Chiap P, Luxen A, Pichon V, Hubert P, Hubert C. Performance evaluation of a MIP for the MISPE-LC determination of p-[ 18F]MPPF and a potential metabolite in human plasma. J Pharm Biomed Anal 2020; 180:113015. [PMID: 31865206 DOI: 10.1016/j.jpba.2019.113015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/11/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
Within the family of serotonin (5-HT) receptors, the 5-HT1A subtype is particularly interesting as it may be involved in various physiological processes or psychological disorders. The p-[18F]MPPF, a highly selective 5-HT1A antagonist, is used for in vivo studies in human or animal by means of positron emission tomography (PET) [1]. In order to selectively extract p-[18F]MPPF and its main metabolites from plasma, molecularly imprinted polymer (MIP) was prepared against these compounds by using the p-MPPF as template. For the control of the selectivity, non-imprinted polymer (NIP) was also synthesized without template. The MIP sorbent, packed in disposable extraction cartridges (DECs), was then evaluated as molecularly imprinted solid-phase extraction (MISPE) prior to the LC determination. The conditions of extraction were evaluated in order to obtain the highest selective retention of the p-[18F]MPPF and its metabolites on this MIP. The MIP selectivity was exploited in the loading and washing steps by adjusting the pH of plasma samples at a suitable value and by selecting mixtures for the washing step to limit the contribution of non-specific interactions. Other important parameters involved in the conditioning and elution steps were also studied. Finally, a pre-validation was carried out with optimal extraction conditions to demonstrate the performance of this MISPE-LC method as a generic method in the context of evaluation of new MISPE for p-[18F]MPPF and its potential for metabolites extraction from human plasma.
Collapse
Affiliation(s)
- F Lecomte
- University of Liège (ULiege), CIRM, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium
| | - J Aerts
- University of Liège (ULiege), GIGA-CRC In VIVO Imaging, Liège, Belgium
| | - A Plenevaux
- University of Liège (ULiege), GIGA-CRC In VIVO Imaging, Liège, Belgium
| | - C Defraiteur
- University of Liège (ULiege), GIGA-CRC In VIVO Imaging, Liège, Belgium
| | - F Chapuis-Hugon
- Dept of Analytical, Bioanalytical Sciences and Miniaturization (LSABM), UMR CBI 8231 (CNRS-ESPCI Paris), ESPCI Paris, PSL University, Paris, France
| | - E Rozet
- Pharmalex, Mont-St-Guibert, Belgium
| | - P Chiap
- Academic Hospital of Liège, Department of Toxicology, GLP-AEPT Unit, CIRM, Liège, Belgium
| | - A Luxen
- University of Liège (ULiege), GIGA-CRC In VIVO Imaging, Liège, Belgium
| | - V Pichon
- Dept of Analytical, Bioanalytical Sciences and Miniaturization (LSABM), UMR CBI 8231 (CNRS-ESPCI Paris), ESPCI Paris, PSL University, Paris, France; Sorbonne Université, Paris, France
| | - Ph Hubert
- University of Liège (ULiege), CIRM, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium
| | - C Hubert
- University of Liège (ULiege), CIRM, Laboratory of Pharmaceutical Analytical Chemistry, Liège, Belgium.
| |
Collapse
|
12
|
Mordon S, Vignion-Dewalle A, Abi-Rached H, Thecua E, Lecomte F, Vicentini C, Deleporte P, Béhal H, Kerob D, Hommel T, Duhamel A, Szeimies R, Mortier L. Testing a new light therapy for the treatment of actinic keratosis. Br J Dermatol 2020. [DOI: 10.1111/bjd.18651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Mordon S, Vignion-Dewalle A, Abi-Rached H, Thecua E, Lecomte F, Vicentini C, Deleporte P, Béhal H, Kerob D, Hommel T, Duhamel A, Szeimies R, Mortier L. 测试一种用于治疗光化性角化症的新的光疗法. Br J Dermatol 2020. [DOI: 10.1111/bjd.18668] [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: 11/30/2022]
|
14
|
Lecomte F, Thecua E, Ziane L, Deleporte P, Duhamel A, Maire C, Staumont-Salle D, Mordon S, Mortier L. Photodynamic Therapy Using a New Painless Light-Emitting Fabrics Device in the Treatment of Extramammary Paget Disease of the Vulva (the PAGETEX Study): Protocol for an Interventional Efficacy and Safety Trial. JMIR Res Protoc 2019; 8:e15026. [PMID: 31793891 PMCID: PMC6918208 DOI: 10.2196/15026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/04/2019] [Indexed: 12/21/2022] Open
Abstract
Background Extramammary Paget disease of the vulva (EMPV) is a rare skin disorder commonly seen in postmenopausal Caucasian females that appears clinically as red, eczematous, pruriginous, and sometimes painful lesions. Although most cases are noninvasive, EMPV may be associated with an underlying or distant adenocarcinoma. EMPV has a chronic and relapsing course. The reference treatment is based on local surgical excision with negative margins. However, disease frequently extends far from the visible lesion, and surgical margins are frequently positive. Topical photodynamic therapy (PDT) is an established treatment modality for various dermatooncologic conditions. For example, red light irradiation with the Aktilite CL 128 and Metvixia (Galderma SA) as a photosensitizing molecule is a conventional protocol approved and widely used in Europe for PDT treatment of actinic keratosis, but this treatment is not yet widely used for EMPV because it has never clearly been demonstrated and is very painful. Objective The aim of the study is to investigate the efficacy and safety relating to the medical device PAGETEX as a new painless PDT device using Metvixia in the treatment of vulvar Paget disease. The primary end point is the disease control rate at 3 months in 30% of the patients included, defined as stability, partial response, or total response, considering the extent of the lesion. Secondary end points are the disease control rate at 6 months, patient quality of life, level of pain experienced by the patient at each PDT session, severity of erythema, presence of protoporphyrin IX in Paget cells after each PDT session, and overall satisfaction level of the patient. Methods The trial is an interventional, exploratory, simple group, nonrandomized, and single center (Lille University Hospital) study. Twenty-four patients will be included according to Simon’s optimal plan. Therapeutic procedure is based on a cycle of two PDT sessions with the PAGETEX medical device at 15-day intervals (Metvixia incubation during 30 minutes and 635 nm red light illumination with a low irradiance for 2 hours and 30 minutes for a total fluence of 12 J/cm²). At the assessment session, 3 months after inclusion, if the control of the disease is partial or null, the patient will complete another cycle of two PDT sessions. A final evaluation will be performed in all patients at 6 months. Analyses will be performed using SAS version 9.4 software (SAS Institute Inc). The characteristics of the patients at baseline will be described; qualitative variables will be described by numbers and percentages, and quantitative variables will be described either by the mean and standard deviation for Gaussian distribution or by the median and interquartile range (ie, 25th and 75th percentiles). The normality of the distributions will be tested by a Shapiro-Wilk test and checked graphically by histograms. Results First patient was included in September 2019 and clinical investigations are planned until August 2022. The final results of this study are expected to be available in January 2023. Conclusions This clinical trial aims to evaluate the efficacy and safety of a new PDT protocol for the treatment of EMPV. The PAGETEX device could become the treatment of choice if it is effective, painless, and easy to implement and use in hospitals. Trial Registration ClinicalTrials.gov NCT03713203; https://clinicaltrials.gov/ct2/show/NCT03713203 International Registered Report Identifier (IRRID) PRR1-10.2196/15026
Collapse
Affiliation(s)
- Fabienne Lecomte
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Elise Thecua
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Laurine Ziane
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Pascal Deleporte
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Alain Duhamel
- EA 2694 - Santé Publique: Epidémiologie et Qualité des Soins, Unité de Biostatistiques, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Cyril Maire
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier et Universitaire de Lille, Lille, France
| | | | - Serge Mordon
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Laurent Mortier
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier et Universitaire de Lille, Lille, France
| |
Collapse
|
15
|
Abi Rached H, Mordon S, Vicentini C, Maire C, Thecua E, Lecomte F, Vignon AS, Deleporte P, Szeimies PM, Mortier L. Étude de phase II évaluant la non-infériorité et la tolérance du dispositif textile lumineux PHOS-ISTOS® comparé à la photothérapie dynamique conventionnelle : un essai randomisé, contrôlé, bi-centrique. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.090] [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: 11/15/2022]
|
16
|
Mordon S, Vignion-Dewalle AS, Abi-Rached H, Thecua E, Lecomte F, Vicentini C, Deleporte P, Béhal H, Kerob D, Hommel T, Duhamel A, Szeimies RM, Mortier L. The conventional protocol vs. a protocol including illumination with a fabric-based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study. Br J Dermatol 2019; 182:76-84. [PMID: 31021404 DOI: 10.1111/bjd.18048] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Topical photodynamic therapy (PDT) using methyl aminolaevulinate is a noninvasive treatment option suitable to treat clinical and subclinical actinic keratosis (AK) over a large area (field cancerization). The most widely used, conventional protocol in Europe includes illumination with a red-light lamp. This illumination commonly causes pain, and patients often cannot complete the treatment. OBJECTIVES The aims of this paper are twofold. The first aim is to introduce a novel protocol, the Phosistos protocol (P-PDT), which includes illumination with a fabric-based biophotonic device. The second and major aim is to assess the noninferiority, in terms of efficacy for PDT of AK, of P-PDT compared with the conventional protocol (C-PDT). METHODS A randomized, controlled, multicentre, intraindividual clinical study was conducted. Forty-six patients with grade I-II AK of the forehead and scalp were treated with P-PDT on one area (280 AK lesions) and with C-PDT on the contralateral area (280 AK lesions). The primary end point was the lesion complete response (CR) rate at 3 months, with an absolute noninferiority margin of -10%. Secondary end points included pain scores, incidence of adverse effects and cosmetic outcome. RESULTS Three months following treatment, the lesion CR rate of P-PDT was noninferior to that of C-PDT (79·3% vs. 80·7%, respectively; absolute difference -1·6%; one-sided 95% confidence interval -4·5% to infinity). The noninferiority of P-PDT to C-PDT in terms of the lesion CR rate remained at the 6-month follow-up (94·2% vs. 94·9%, respectively; absolute difference -0·6%; one-sided 95% confidence interval -2·7% to infinity). Moreover, the pain score at the end of illumination was significantly lower for P-PDT than for C-PDT (mean ± SD 0·3 ± 0·6 vs. 7·4 ± 2·3; P < 0·001). CONCLUSIONS P-PDT is noninferior to C-PDT in terms of efficacy for treating AK of the forehead and scalp and resulted in much lower pain scores and fewer adverse effects. What's already known about this topic? Topical photodynamic therapy using methyl aminolaevulinate is effective for treating actinic keratosis. In Europe, the conventional protocol involves illumination with a red-light lamp. Unfortunately, pain is often experienced by patients undergoing this protocol. An alternative protocol that uses daylight illumination has recently been shown to be as effective as the conventional protocol while being nearly painless. However, this alternative protocol can be conducted only in suitable weather conditions. What does this study add? The Phosistos protocol is demonstrated to be as effective as the conventional protocol, nearly as painless as the daylight protocols and suitable year round for treatment of actinic keratosis.
Collapse
Affiliation(s)
- S Mordon
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - A S Vignion-Dewalle
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - H Abi-Rached
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Dermatology, CHU Lille, F-59000, Lille, France
| | - E Thecua
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - F Lecomte
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - C Vicentini
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Dermatology, CHU Lille, F-59000, Lille, France
| | - P Deleporte
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - H Béhal
- University of Lille, CHU Lille, EA 2694 - Santé Publique: Epidémiologie et Qualité des Soins, Unité de Biostatistiques, F-59000, Lille, France
| | - D Kerob
- Galderma International SAS, F-92927, La Défense, France
| | - T Hommel
- Department of Dermatology and Allergology, Klinikum Vest GmbH, D-45657, Recklinghausen, Germany
| | - A Duhamel
- University of Lille, CHU Lille, EA 2694 - Santé Publique: Epidémiologie et Qualité des Soins, Unité de Biostatistiques, F-59000, Lille, France
| | - R M Szeimies
- Department of Dermatology and Allergology, Klinikum Vest GmbH, D-45657, Recklinghausen, Germany
| | - L Mortier
- University of Lille, INSERM, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France.,Department of Dermatology, CHU Lille, F-59000, Lille, France
| |
Collapse
|
17
|
Lecomte F, Vignion-Dewalle AS, Vicentini C, Thecua E, Deleporte P, Duhamel A, Mordon S, Mortier L. Evaluating the Noninferiority of a New Photodynamic Therapy (Flexitheralight) Compared With Conventional Treatment for Actinic Keratosis: Protocol for a Phase 2 Study. JMIR Res Protoc 2019; 8:e11530. [PMID: 31025952 PMCID: PMC6658309 DOI: 10.2196/11530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/28/2018] [Accepted: 10/15/2018] [Indexed: 12/19/2022] Open
Abstract
Background Actinic keratosis (AK) is characterized by preinvasive, cancerous lesions on sun-exposed skin that negatively affect patient quality of life and may progress to invasive squamous cell carcinoma (SCC). If untreated, AK may either regress or progress to SCC, with significant morbidity and possible lethal outcomes. The most commonly used treatments for AK are cryotherapy, topical chemotherapy and, more recently, photodynamic therapy (PDT). This clinical study is part of a project that aims to create specific light-emitting fabrics (LEFs) that strongly improve the efficiency and reliability of PDT as a treatment for AK. Objective This study aims to compare the efficacy and tolerability of a new PDT protocol involving the Flexitheralight device (N-PDT) with the classical protocol involving the Aktilite CL 128 device (C-PDT; Galderma Laboratories) for the treatment of AK. All participants receive both protocols. The primary objective of this study is to compare the lesion response rate after 3 months of N-PDT with C-PDT. Secondary objectives are evaluations of pain and local tolerance during treatment, clinical evolution of the subject's skin, and evaluations of patient quality of life and satisfaction. Methods The study is a split-face, intraindividual comparison of two PDT protocols. The total number of patients recruited was 42. Patients were exposed to a continuous red light with the Aktilite CL 128 device on one side of the face and to fractionated red illumination with the new device, Flexitheralight, on the other side of the face. Males or females over the age of 18 years with a clinical diagnosis of at least 10 previously untreated, nonpigmented, nonhyperkeratotic grade I and II AK lesions of the forehead and/or scalp were included and were recruited from the Department of Dermatology of the Centre Hospitalier Universitaire de Lille. The patients came to the investigational center for one treatment session (day 1), and they were followed up after 7 days, 3 months and 6 months. A second treatment session was performed on day 111 in cases in which an incomplete response was observed at the 3-month follow-up. Data will be analyzed using SAS software version 9.4 (SAS Institute Inc). Continuous variables will be reported as means and standard deviations, and categorical variables will be reported as frequencies and percentages. The Shapiro-Wilk test will be used to assess the normality of the distribution. Results The clinical investigation was performed by July 2018. Data analysis was performed at the end of 2018, and results are expected to be published in early 2019. Conclusions This phase II clinical trial aims to evaluate the noninferior efficacy and superior tolerability of N-PDT compared to that of C-PDT. If N-PDT is both efficacious and tolerable, N-PDT could become the treatment of choice for AK due to its ease of implementation in hospitals. Trial Registration ClinicalTrials.gov NCT03076918; https://clinicaltrials.gov/ct2/show/NCT03076918 (archived by WebCite at http://www.webcitation.org/771KA0SSK) International Registered Report Identifier (IRRID) DERR1-10.2196/11530
Collapse
Affiliation(s)
- Fabienne Lecomte
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Anne Sophie Vignion-Dewalle
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Claire Vicentini
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Elise Thecua
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Pascal Deleporte
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Alain Duhamel
- EA 2694 - Santé Publique: épidémiologie et Qualité des Soins, Unité de Biostatistiques, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Serge Mordon
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| | - Laurent Mortier
- U1189 - Image Assisted Laser Therapies for Oncology, Inserm, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier et Universitaire de Lille, Université de Lille, Lille, France
| |
Collapse
|
18
|
Vignion-Dewalle AS, Abi Rached H, Thecua E, Lecomte F, Deleporte P, Béhal H, Hommel T, Duhamel A, Szeimies RM, Mortier L, Mordon S. A New Light-Emitting, Fabric-Based Device for Photodynamic Therapy of Actinic Keratosis: Protocol for a Randomized, Controlled, Multicenter, Intra-Individual, Phase II Noninferiority Study (the Phosistos Study). JMIR Res Protoc 2019; 8:e12990. [PMID: 31025953 PMCID: PMC6658310 DOI: 10.2196/12990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Actinic keratosis (AK) is a common early in situ skin carcinoma caused by long-term sun exposure and usually develops on sun-exposed skin areas. Left untreated, AK may progress to squamous cell carcinoma. To prevent such risk, most clinicians routinely treat AK. Therapy options for AK include cryotherapy, topical treatments, curettage, excision surgery, and photodynamic therapy (PDT). OBJECTIVE The aim of this study is to assess the noninferiority, in terms of efficacy at 3 months, of a PDT protocol involving a new light-emitting device (PDT using the Phosistos protocol [P-PDT]) compared with the conventional protocol (PDT using the conventional protocol [C-PDT]) in the treatment of AK. METHODS In this randomized, controlled, multicenter, intra-individual, phase II noninferiority clinical study, subjects with AK of the forehead and scalp are treated with P-PDT on one area and with C-PDT on the contralateral area. In both areas, lesions are prepared and methyl aminolevulinate (MAL) is applied. Thirty minutes after MAL application, the P-PDT area is exposed to red light at low irradiance (1.3 mW/cm2) for 2.5 hours so that a light dose of 12 J/cm2 is achieved. In the control area (C-PDT area), a 37 J/cm2 red light irradiation is performed 3 hours after MAL application. Recurrent AK at 3 months is retreated. The primary end point is the lesion complete response rate at 3 months. Secondary end points include pain scores at 1 day, local tolerance at 7 days, lesion complete response rate at 6 months, cosmetic outcome at 3 and 6 months, and patient-reported quality of life and satisfaction throughout the study. A total of 45 patients needs to be recruited. RESULTS Clinical investigations are complete: 46 patients were treated with P-PDT on one area (n=285 AK) and with C-PDT on the contralateral area (n=285 AK). Data analysis is ongoing, and statistical results will be available in the first half of 2019. CONCLUSIONS In case of noninferiority in efficacy and superiority in tolerability of P-PDT compared with C-PDT, P-PDT could become the treatment of choice for AK. TRIAL REGISTRATION ClinicalTrials.gov NCT03076892; https://clinicaltrials.gov/ct2/show/NCT03076892 (Archived by WebCite at http://www.webcitation.org/779qqVKek). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12990.
Collapse
Affiliation(s)
- Anne-Sophie Vignion-Dewalle
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Henry Abi Rached
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Elise Thecua
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Fabienne Lecomte
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Pascal Deleporte
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Hélène Béhal
- EA 2694 - Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Theresa Hommel
- Department of Dermatology and Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - Alain Duhamel
- EA 2694 - Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Rolf-Markus Szeimies
- Department of Dermatology and Allergology, Klinikum Vest GmbH, Recklinghausen, Germany
| | - Laurent Mortier
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France.,Department of Dermatology, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Serge Mordon
- U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Université de Lille, INSERM, Centre Hospitalier Universitaire de Lille, Lille, France
| |
Collapse
|
19
|
Vicentini C, Vignion‐Dewalle A, Thecua E, Lecomte F, Maire C, Deleporte P, Béhal H, Kerob D, Duhamel A, Mordon S, Mortier L. A new protocol using a light‐emitting fabric for PDT of AK. Br J Dermatol 2019. [DOI: 10.1111/bjd.17655] [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: 11/29/2022]
|
20
|
Vicentini C, Vignion‐Dewalle A, Thecua E, Lecomte F, Maire C, Deleporte P, Béhal H, Kerob D, Duhamel A, Mordon S, Mortier L. 一种利用发光纤维进行 AK PDT 的新方案. Br J Dermatol 2019. [DOI: 10.1111/bjd.17671] [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: 12/01/2022]
|
21
|
Vicentini C, Vignion-Dewalle AS, Thecua E, Lecomte F, Béhal H, Maire C, Tylcz JB, Abi-Rached H, Mortier L, Mordon S. Photodynamic therapy for actinic keratosis of the forehead and scalp with the Aktilite CL 128: Is there a cut-off value for PpIX-weighted irradiance for effective treatment? Photodermatol Photoimmunol Photomed 2019; 35:232-237. [DOI: 10.1111/phpp.12457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/22/2019] [Accepted: 02/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Claire Vicentini
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | | | - Elise Thecua
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Fabienne Lecomte
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Hélène Béhal
- Univ. Lille, CHU Lille; EA 2694 - Santé Publique: épidémiologie et qualité des soins; Unité de Biostatistiques; Lille France
| | - Cyril Maire
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Jean-Baptiste Tylcz
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| | - Henry Abi-Rached
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Laurent Mortier
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
- Department of Dermatology; CHU Lille; Lille France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille; U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology; Lille France
| |
Collapse
|
22
|
Vicentini C, Vignion‐Dewalle A, Thecua E, Lecomte F, Maire C, Deleporte P, Béhal H, Kerob D, Duhamel A, Mordon S, Mortier L. Photodynamic therapy for actinic keratosis of the forehead and scalp: a randomized, controlled, phaseIIclinical study evaluating the noninferiority of a new protocol involving irradiation with a light‐emitting, fabric‐based device (the Flexitheralight protocol) compared with the conventional protocol involving irradiation with the AktiliteCL128 lamp. Br J Dermatol 2019; 180:765-773. [DOI: 10.1111/bjd.17350] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Affiliation(s)
- C. Vicentini
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
- Department of Dermatology CHU Lille F‐59000 LilleFrance
| | - A.S. Vignion‐Dewalle
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
| | - E. Thecua
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
| | - F. Lecomte
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
| | - C. Maire
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
- Department of Dermatology CHU Lille F‐59000 LilleFrance
| | - P. Deleporte
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
| | - H. Béhal
- Univ. Lille CHU Lille EA 2694 – Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques F‐59000 LilleFrance
| | - D. Kerob
- Galderma International SAS F‐92927 La Défense France
| | - A. Duhamel
- Univ. Lille CHU Lille EA 2694 – Santé Publique: épidémiologie et qualité des soins, Unité de Biostatistiques F‐59000 LilleFrance
| | - S. Mordon
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
| | - L. Mortier
- Univ. Lille INSERM, CHU Lille, U1189 – ONCO‐THAI – Image Assisted Laser Therapy for Oncology F‐59000 LilleFrance
- Department of Dermatology CHU Lille F‐59000 LilleFrance
| |
Collapse
|
23
|
Le Calvé C, Mortier L, Vicentini C, Delaporte E, Maire C, Thecua E, Lecomte F, Rached HA, Mordon S, Deleporte P, Vignon AS. Traitement de la folliculite décalvante par PDT avec dispositifs lumineux textiles : à propos de 2 observations. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.264] [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]
|
24
|
Noël Racine A, Van Hoye A, Baron A, Lecomte F, Honta M, Vuillemin A. Development of a local HEPA policy analysis tool (CAPLA-Santé) in France. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A Van Hoye
- Université de Lorraine, APEMAC, Vandoeuvre-les-Nancy, France
| | - A Baron
- Société Française de Santé Publique, Laxou, France
| | - F Lecomte
- Société Française de Santé Publique, Laxou, France
| | - M Honta
- Université de Bordeaux, Centre Emile Durkheim, Pessac, France
| | - A Vuillemin
- Université Côte d'Azur, LAMHESS, Nice, France
| |
Collapse
|
25
|
Vignion-Dewalle AS, Baert G, Thecua E, Lecomte F, Vicentini C, Abi-Rached H, Mortier L, Mordon S. Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months? Lasers Surg Med 2018; 50:576-589. [PMID: 29667728 DOI: 10.1002/lsm.22827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Topical photodynamic therapy is an established treatment modality for various dermatological conditions, including actinic keratosis. In Europe, the approved protocols for photodynamic therapy of actinic keratosis involve irradiation with either an Aktilite CL 128 lamp or daylight, whereas irradiation with the Blu-U illuminator is approved in the United States. Many other protocols using irradiation by a variety of light sources are also clinically efficient. OBJECTIVES This paper aims to compare 10 different protocols with clinically proven efficacy for photodynamic therapy of actinic keratosis and the available spectral irradiance of the light source. Effective irradiance, effective light dose, and local damage are compared. We also investigate whether there is an association between the complete response rate at 3 months and the effective light dose or local damage. METHODS The effective irradiance, also referred to as protoporphyrin IX-weighted irradiance, is obtained by integrating the spectral irradiance weighted by the normalized absorption spectrum of protoporphyrin IX over the wavelength. Integrating the effective irradiance over the irradiation time yields the effective light dose, which is also known as the protoporphyrin IX-weighted light dose. Local damage, defined as the total cumulative singlet oxygen molecules produced during treatment, is estimated using mathematical modeling of the photodynamic therapy process. This modeling is based on an iterative procedure taking into account the spatial and temporal variations in the protoporphyrin IX absorption spectrum during treatment. RESULTS The protocol for daylight photodynamic therapy on a clear sunny day, the protocol for daylight photodynamic therapy on an overcast day, the photodynamic therapy protocol for a white LED lamp for operating rooms and the photodynamic therapy protocol for the Blu-U illuminator perform better than the six other protocols-all involving red light illumination-in terms of both effective light dose and local damage. However, no association between the complete response rate at 3 months and the effective light dose or local damage was found. CONCLUSIONS Protocols that achieve high complete response rates at 3 months and low pain scores should be preferred regardless of the effective light dose and local damage. Lasers Surg. Med. 50:576-589, 2018. © 2018 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Anne-Sophie Vignion-Dewalle
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Gregory Baert
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Elise Thecua
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Fabienne Lecomte
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| | - Claire Vicentini
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Henry Abi-Rached
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Laurent Mortier
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France.,Department of Dermatology, CHU Lille, Lille, F-5900, France
| | - Serge Mordon
- Univ. Lille, INSERM, CHU Lille, U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology, Lille, F-59000, France
| |
Collapse
|
26
|
Nieuwjaer N, Desfrançois C, Lecomte F, Manil B, Soorkia S, Broquier M, Grégoire G. Photodissociation Spectroscopy of Cold Protonated Synephrine: Surprising Differences between IR–UV Hole-Burning and IR Photodissociation Spectroscopy of the O–H and N–H Modes. J Phys Chem A 2018; 122:3798-3804. [DOI: 10.1021/acs.jpca.8b01422] [Citation(s) in RCA: 4] [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: 11/30/2022]
Affiliation(s)
- N. Nieuwjaer
- Laboratoire de Physique des Lasers, CNRS, Université Paris 13, Sorbonne Paris Cité, 93430 Villetaneuse, France
| | - C. Desfrançois
- Laboratoire de Physique des Lasers, CNRS, Université Paris 13, Sorbonne Paris Cité, 93430 Villetaneuse, France
| | - F. Lecomte
- Laboratoire de Physique des Lasers, CNRS, Université Paris 13, Sorbonne Paris Cité, 93430 Villetaneuse, France
| | - B. Manil
- Laboratoire de Physique des Lasers, CNRS, Université Paris 13, Sorbonne Paris Cité, 93430 Villetaneuse, France
| | - S. Soorkia
- Institut des Sciences Moléculaires d’Orsay (ISMO), CNRS, Univ. Paris Sud, Université Paris-Saclay, F-91405 Orsay, France
- Centre Laser de l’Université Paris-Sud (CLUPS/LUMAT), Univ. Paris-Sud, CNRS, IOGS, Université Paris-Saclay, F-91405 Orsay, France
| | - M. Broquier
- Institut des Sciences Moléculaires d’Orsay (ISMO), CNRS, Univ. Paris Sud, Université Paris-Saclay, F-91405 Orsay, France
- Centre Laser de l’Université Paris-Sud (CLUPS/LUMAT), Univ. Paris-Sud, CNRS, IOGS, Université Paris-Saclay, F-91405 Orsay, France
| | - G. Grégoire
- Institut des Sciences Moléculaires d’Orsay (ISMO), CNRS, Univ. Paris Sud, Université Paris-Saclay, F-91405 Orsay, France
- Centre Laser de l’Université Paris-Sud (CLUPS/LUMAT), Univ. Paris-Sud, CNRS, IOGS, Université Paris-Saclay, F-91405 Orsay, France
| |
Collapse
|
27
|
Mordon S, Vignion-Dewalle AS, Thecua E, Vicentini C, Maire C, Deleporte P, Baert G, Lecomte F, Mortier L. Can daylight-PDT be performed indoor? GIORN ITAL DERMAT V 2018; 153:811-816. [PMID: 29417802 DOI: 10.23736/s0392-0488.18.05907-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Natural DayLight-mediated PhotoDynamic Therapy (NDL-PDT) is an efficacious treatment option for thin actinic keratosis that offers advantages over conventional PDT in terms of tolerability and cost. It is now accepted that the minimum criteria required for effective NDL-PDT is a dose of 4 J/cm² with a treatment time of 2 hours and a minimum temperature of 10 °C, corresponding to a minimum illuminance of 11,000 lux. This value is easily achievable: 20,000 lux can be obtained during a typical overcast day at midday. It can reach 110,000 lux with a bright sunlight. However, it is limited to certain times of the year at our latitude. However rain and cold temperatures appear the main limitations of NDL-PDT. Greenhouses make possible to perform the illumination even in harsh weather conditions. Furthermore, it is difficult to install a greenhouse everywhere. Several solutions are now proposed to carry out indoor illumination so-called artificial white light or simulated daylight (SDL-PDT). Illumination sources installed at the ceiling of the treatment room is one option. Several lamp pairs can be combined to illuminate groups of patients simultaneously. A surgical theatre light can be used or dedicated systems using white LEDs can be used to deliver the required illumination dose. In conclusion, Indoor lightning (or simulated daylight: SDL-PDT or Artificial White Light: AWL) could offer an interesting alternative to NDL-PDT.
Collapse
Affiliation(s)
- Serge Mordon
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France - serge.mordon @inserm.fr
| | - Anne S Vignion-Dewalle
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France
| | - Elise Thecua
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France
| | - Claire Vicentini
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France.,Department of Dermatology, CHU Lille, Lille, France
| | - Cyril Maire
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France.,Department of Dermatology, CHU Lille, Lille, France
| | - Pascal Deleporte
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France
| | - Gregory Baert
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France
| | - Fabienne Lecomte
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France
| | - Laurent Mortier
- Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille University, Lille, France.,Department of Dermatology, CHU Lille, Lille, France
| |
Collapse
|
28
|
Lelaidier R, Balança B, Boet S, Faure A, Lilot M, Lecomte F, Lehot JJ, Rimmelé T, Cejka JC. Use of a hand-held digital cognitive aid in simulated crises: the MAX randomized controlled trial. Br J Anaesth 2017; 119:1015-1021. [DOI: 10.1093/bja/aex256] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 11/12/2022] Open
|
29
|
Garcia RL, Nieuwjaer N, Desfrançois C, Lecomte F, Leite SD, Manil B, Broquier M, Grégoire G. Vibronic spectra of protonated hydroxypyridines: contributions of prefulvenic and planar structures. Phys Chem Chem Phys 2017; 19:8258-8268. [DOI: 10.1039/c6cp08623c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The UV photofragmentation spectra of cold protonated hydroxypyridines display well resolved vibrational structures, interpreted with calculations at the CC2 level.
Collapse
Affiliation(s)
- R. Lozada Garcia
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - N. Nieuwjaer
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - C. Desfrançois
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - F. Lecomte
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - S. D. Leite
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - B. Manil
- Laboratoire de Physique des Lasers
- CNRS
- Université Paris 13
- Sorbonne Paris Cité
- France
| | - M. Broquier
- Institut des Sciences Moléculaires d'Orsay (ISMO)
- CNRS
- Univ. Paris Sud
- Université Paris-Saclay
- F-91405 Orsay
| | - G. Grégoire
- Institut des Sciences Moléculaires d'Orsay (ISMO)
- CNRS
- Univ. Paris Sud
- Université Paris-Saclay
- F-91405 Orsay
| |
Collapse
|
30
|
Kone V, Lecomte F, Randriamanana D, Pourriat JL, Claessens YE, Vidal-Trecan G. Impact of a pilot team on patients' pain reduction and satisfaction in an emergency department: A before-and-after observational study. Rev Epidemiol Sante Publique 2016; 64:59-66. [PMID: 26968458 DOI: 10.1016/j.respe.2015.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 09/24/2015] [Accepted: 11/25/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pain management and patient satisfaction were targeted in the emergency department of a Paris university hospital. In 1999, 77.0% of patients complained of pain on arrival and more than half of patients did not experience pain relief at discharge. The purpose of the study was to evaluate the outcomes of the implementation of a team piloting pain management on pain reduction and pain care satisfaction. METHOD Two cross-sectional surveys (04/10/1999 to 19/10/1999 and 03/04/2007 to 18/04/2007) were conducted before and after a team piloting pain management was deployed in the emergency department. Consecutive patients age 18 years and older who visited the department suffering from pain were given structured questionnaires that validated scales scoring pain upon arrival and at discharge. Patients' files were analyzed using structured forms. The parameters associated with pain reduction and patient satisfaction were sought. RESULTS In 2007, 65.0% of patients had their pain relieved vs. 35.1% in 1999 (P<0.001); 60.2% were satisfied with the pain care received vs. 39.8%. Pain management (e.g. waiting time ≤ 20 min: 47.6% vs. 20.8%; interventions on pain before the physician's examination: 63.0% vs. 13.8%; and pain reassessment after intervention: 13.8% vs. 4.5%) improved. Both pain reduction and patient satisfaction were significantly associated with intervention before the physician's examination. Pain reduction was independently and positively associated with time of survey, triage level (depending on the severity of their condition), pain intensity on arrival, and negatively associated with discharge without hospitalization. Satisfaction was independently and positively associated with waiting time before examination (0-20 min) and the absence of procedural pain. CONCLUSION The implementation of a team piloting pain management seemed to have had positive effects on pain management in the emergency department. However, respectively, 56.2% and 39.8% of patients remained without pain relief and dissatisfied with pain management at the end of their visit.
Collapse
Affiliation(s)
- V Kone
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - F Lecomte
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France
| | - D Randriamanana
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - J-L Pourriat
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France
| | - Y-E Claessens
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France
| | - G Vidal-Trecan
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Research unit (Inserm U1153) methods team, methods of therapeutic evaluation of chronic diseases, research center epidemiology and biostatistics, Sorbonne Paris Cité, 75004 Paris, France.
| |
Collapse
|
31
|
Longchal G, Lecomte F. Une étiologie rare de la syncope : la rupture atraumatique de rate. Ann Fr Med Urgence 2015. [DOI: 10.1007/s13341-015-0572-1] [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: 10/23/2022]
|
32
|
Rozet E, Dewé W, Chiap P, Lecomte F, Hubert P. LE TRANSFERT D’UNE MÉTHODE DE DOSAGE AUTOMATISÉE DE LA NORADRÉNALINE DANS L’URINE HUMAINE: UTILISATION DE L’ERREUR TOTALE COMME CRITÈRE DE DÉCISION. Acta Clin Belg 2014. [DOI: 10.1179/acb.2006.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
33
|
Houbart V, Cobraiville G, Lecomte F, Debrus B, Hubert P, Fillet M. Development of a nano-liquid chromatography on chip tandem mass spectrometry method for high-sensitivity hepcidin quantitation. J Chromatogr A 2011; 1218:9046-54. [PMID: 22055522 DOI: 10.1016/j.chroma.2011.10.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 10/16/2022]
Abstract
Microfluidic LC systems present undeniable advantages over classical LC in terms of sensitivity. Hepcidin, a peptide marker of clinical disorders linked to iron metabolism, was used as model to demonstrate peptide quantification potentialities of LC-chip coupled to a nanoelectrospray source ion trap mass spectrometer in an aqueous sample. First, stable isotope labelled hepcidin was chosen as internal standard and gradient as well as sample compositions were optimised using design of experiments as development tool. The method was then prevalidated using accuracy profiles in order to select the most appropriate response function and to confirm the ability of the technique to quantify low hepcidin concentration. A reliable and very sensitive quantitation method was finally obtained using this integrated microfluidic technology. Indeed, good results with respect to accuracy, trueness and precision were achieved, as well as a very low limit of quantitation (0.07 ng/ml). Method suitability of nano-LC on chip tandem mass spectrometry for hepcidin quantitation was also demonstrated in complex media such as human plasma.
Collapse
Affiliation(s)
- V Houbart
- Laboratory of Analytical Pharmaceutical Chemistry, Department of Pharmacy, CIRM, University of Liège, Belgium
| | | | | | | | | | | |
Collapse
|
34
|
Debrus B, Lebrun P, Kindenge JM, Lecomte F, Ceccato A, Caliaro G, Mbay JMT, Boulanger B, Marini R, Rozet E, Hubert P. Innovative high-performance liquid chromatography method development for the screening of 19 antimalarial drugs based on a generic approach, using design of experiments, independent component analysis and design space. J Chromatogr A 2011; 1218:5205-15. [DOI: 10.1016/j.chroma.2011.05.102] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 05/30/2011] [Accepted: 05/30/2011] [Indexed: 11/15/2022]
|
35
|
Nistor I, Cao M, Debrus B, Lebrun P, Lecomte F, Rozet E, Angenot L, Frederich M, Oprean R, Hubert P. Application of a new optimization strategy for the separation of tertiary alkaloids extracted from Strychnos usambarensis leaves. J Pharm Biomed Anal 2011; 56:30-7. [DOI: 10.1016/j.jpba.2011.04.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 04/28/2011] [Indexed: 10/18/2022]
|
36
|
Gillet A, Compère P, Lecomte F, Hubert P, Ducat E, Evrard B, Piel G. Liposome surface charge influence on skin penetration behaviour. Int J Pharm 2011; 411:223-31. [PMID: 21458550 DOI: 10.1016/j.ijpharm.2011.03.049] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/21/2011] [Accepted: 03/22/2011] [Indexed: 11/30/2022]
Abstract
Vesicular systems have shown their ability to increase dermal and transdermal drug delivery. Their mechanism of drug transport into and through the skin has been investigated but remains a much debated question. Several researchers have outlined that drug penetration can be influenced by modifying the surface charge of liposomes. In the present work we study the influence of particle surface charge on skin penetration. The final purpose is the development of a carrier system which is able to enhance the skin delivery of two model drugs, betamethasone and betamethasone dipropionate. Liposomes were characterised by their size, morphology, zeta potential, encapsulation efficiency and stability. Ex vivo diffusion studies using Franz diffusion cells were performed. Confocal microscopy was performed to visualise the penetration of fluorescently labelled liposomes into the skin. This study showed the potential of negatively charged liposomes to enhance the skin penetration of betamethasone and betamethasone dipropionate.
Collapse
Affiliation(s)
- A Gillet
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, CIRM, University of Liège, CHU, Tour 4, Bat B36, 1 Avenue de l'Hôpital, 4000 Liège, Belgium.
| | | | | | | | | | | | | |
Collapse
|
37
|
Hubert C, Houari S, Lecomte F, Houbart V, De Bleye C, Fillet M, Piel G, Rozet E, Hubert P. Development and validation of a sensitive solid phase extraction/hydrophilic interaction liquid chromatography/mass spectrometry method for the accurate determination of glucosamine in dog plasma. J Chromatogr A 2010; 1217:3275-81. [DOI: 10.1016/j.chroma.2010.01.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 12/02/2009] [Accepted: 01/11/2010] [Indexed: 11/24/2022]
|
38
|
Lecomte F, Kone V, Ginsburg C, Pourriat JL, Claessens YE, Vidal-Trecan G. 044 Impact of the role of a physician in charge of pane management in the emergency room of a university hospital. BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041632.5] [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: 11/04/2022]
|
39
|
Poully JC, Schermann JP, Nieuwjaer N, Lecomte F, Grégoire G, Desfrançois C, Garcia GA, Nahon L, Nandi D, Poisson L, Hochlaf M. Photoionization of 2-pyridone and 2-hydroxypyridine. Phys Chem Chem Phys 2010; 12:3566-72. [DOI: 10.1039/b923630a] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
40
|
Li X, Wang H, Bowen KH, Grégoire G, Lecomte F, Schermann JP, Desfrançois C. The parent anion of the RGD tripeptide: Photoelectron spectroscopy and quantum chemistry calculations. J Chem Phys 2009; 130:214301. [DOI: 10.1063/1.3137095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
|
41
|
Koné V, Gault N, Lafoix C, Lecomte F, Ginsburg C, Vidal-Trécan G. L’amélioration de la prise en charge de la douleur dans un service d’accueil en urgence augmente-t-elle la satisfaction des patients ? Résultats d’une étude comparative avant–après instauration de la prise en charge de la douleur dès l’arrivée. Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.02.123] [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] Open
|
42
|
Couturaud F, Pernod G, Pison C, Mismetti P, Sanchez O, Meyer G, Parent F, Girard P, Simonneau G, Drouet L, Gueret P, Jego P, Delaval P, Duhamel E, Gruel Y, Delahousse B, Regina S, Pottier P, Connaud J, Lecomte F, Provost K, Vilmans N, Gosset X, Bura-Rivière A, Meach G, Lacut K, Bosson JL, Guillot K, Mottier D, Leroyer C. [Prolongation of anti vitamin K treatment for 18 months versus placebo after 6 months treatment of a first episode of ideopathic pulmonary embolism: a mutlicentre, randomised double blind trail. The PADIS-EP Trial]. Rev Mal Respir 2008; 25:885-93. [PMID: 18946418 DOI: 10.1016/s0761-8425(08)74358-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND After stopping a 3 to 6 months course of oral anticoagulation for a first episode of idiopathic venous thromboembolism (VTE), the risk of recurrent VTE is high (10% per year). In this setting, international guidelines recommend at least 6 months treatment. However, this recommendation is not satisfactory for the following reasons: (1) no randomized trial has compared 6 months to extended duration (2 years) anticoagulation; and (2), even though the frequency of recurrent VTE is similar after pulmonary embolism (PE) and deep vein thrombosis (DVT), the fatality rate of recurrent VTE after PE is higher than that after DVT. METHODS A French multicentre double blind randomized trial. The main objective is to demonstrate, after a first episode of symptomatic idiopathic PE treated for 6 months using a vitamin K antagonist, that extended anticoagulation for 18 months (INR between 2 and 3) is associated with an increased benefit / risk ratio (recurrent VTE and severe anticoagulant-related bleeding) compared to placebo. The double blind evaluation is ensured using by active warfarin and placebo, and blinded INR. The protocol was approved by the ethics board of the Brest Hospital on the 7th of March 2006. For an alpha risk of 5% and a beta risk of 20%, the estimated sample size is 374 patients. EXPECTED RESULTS This study has the potential to: (1) demonstrate that the benefit / risk ratio of extended anticoagulation for 18 months is higher than that observed with placebo in patients with a first episode of idiopathic PE initially treated for 6 months, during and after the treatment period; and (2) to validate or invalidate the contribution of isotope lung scans, lower limb Doppler ultrasound and D-Dimer at 6 months of treatment as predictors of recurrent VTE (medico-economic analysis included).
Collapse
Affiliation(s)
- F Couturaud
- Département de Médecine interne et pneumologie, CHU de Brest, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Zalfen AM, Nizet D, Jérôme C, Jérôme R, Frankenne F, Foidart JM, Maquet V, Lecomte F, Hubert P, Evrard B. Controlled release of drugs from multi-component biomaterials. Acta Biomater 2008; 4:1788-96. [PMID: 18583206 DOI: 10.1016/j.actbio.2008.05.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 04/24/2008] [Accepted: 05/14/2008] [Indexed: 01/22/2023]
Abstract
In order to control their release, drugs are encapsulated into systems which are expected to provide a certain site with a predetermined amount of drug over a well-defined period of time. Here we report on a multi-component drug delivery biomaterial that consists of a hydrogel matrix in which drug-loaded biodegradable microcarriers are dispersed, and whose potential applications could be found in the design of implantable devices with long-term activity, as required by contraceptive and hormone replacement treatments. The release profile of the drug can actually be tuned by the complex interplay of several release mechanisms, including the permeability and eventually the degradation rate of the microcarriers and the diffusion through the hydrogel. The hydrogel consisted of 2-hydroxyethyl methacrylate cross-linked by ethylene glycol dimethacrylate. The microcarriers were biodegradable poly-epsilon-caprolactone (PCL) microspheres in which active molecules, such as levonorgestrel (LNG), were encapsulated. The hydrogels were characterized by water swelling, thermal properties, LNG diffusion through drug-free and drug-depleted hydrogel membranes and LNG release from devices with drug dispersed in the hydrogel. The PCL microspheres were observed by scanning electron microscopy; their size distribution, LNG loading and release were also investigated. The hydrogel-microsphere assemblies were characterized in terms of the distribution of the microspheres within the hydrogel, water swelling and the release of the encapsulated molecules. The developed device, due to its composite structure, has the ability to combine several release mechanisms, leading to drug release obeying zero-order kinetics for most of the time.
Collapse
Affiliation(s)
- A M Zalfen
- Center for Education and Research on Macromolecules, University of Liège, Liège 4000, Belgium.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Lecomte F, Dodson J. Glacial cycles promote the evolution of the intra-specific diversity in high latitude marine fishes. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.04.569] [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: 11/25/2022]
|
45
|
Wavreille G, Frick L, Cassio JB, Soenen M, Chantelot C, Lecomte F. [A secondary bleeding false aneurysm of the superomedial genicular artery after distal femoral epiphysiodesis: a case report]. Rev Chir Orthop Reparatrice Appar Mot 2008; 94:193-196. [PMID: 18420066 DOI: 10.1016/j.rco.2007.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2007] [Indexed: 05/26/2023]
Abstract
A 16-year-old male developed a false aneurysm of the superomedial genicular artery five weeks after medial distal femoral epiphysiodesis. The aneurysm was revealed by inexhaustible bleeding from the medial aspect of the knee and the presence of acute hemorrhage which resolved spontaneously. Physical examination disclosed disunion of the surgical wound at the apex of a pulsatory tumefaction over the medial aspect of the knee. AngioCT enabled the diagnosis of a false aneurysm of the superomedial genicular artery. Emergency surgery was undertaken to drain the hematoma and exclude the false aneurysm by ligating the superomedial genicular artery.
Collapse
Affiliation(s)
- G Wavreille
- Clinique dorthopédie, hôpital Roger-Salengro, CHRU de Lille, boulevard Emile-Laine, 59045 Lille cedex, France.
| | | | | | | | | | | |
Collapse
|
46
|
Abstract
PURPOSE OF THE STUDY Resection of the proximal row of the carpus which simplifies the radiocarpal joint is mainly performed for advanced collapse. With the development of several therapeutic alternatives, further study of outcome is warranted to better identify indications. MATERIAL AND METHODS Twenty-five patients who underwent proximal row carpectomy between January 1999 and February 2004 were reviewed clinically and radiologically at 30 months mean follow-up. Three main etiologies were noted: scaphoid fracture (n=9), scapholunate dissociation (n=9), Kienböck disease (n=6). A posterior approach was used for all patients. Outcome was assessed clinically (pain, force, mobility), radiologically (carpal height, radiocapital space), and subjectively by the patient. Resumption of occupational activity was noted as were the Cooney and Culp scores. RESULTS Average flexion-extension was 60 degrees . Average wrist force was 65% of the healthy side. Pain improved in 88% of wrists and the mean subjective score was 15.2. The mean Cooney and Culp scores were 58 and 67.8 respectively. A reduction in the height of the new articular space was not correlated with less favorable clinical outcome. Outcome in patients with Kienböck disease were less favorable than in trauma patients but the difference did not reach significance. DISCUSSION First row carpectomy is a paliative procedure which should only be performed when conservative treatment is no longer a valid option. Indications should be limited to Watson grade II, before cartilaginous damage affects the head of the capitatum. New techniques such as fusion-shortening, theoretically similar to resection, can now be used for advances collapse. We prefer resection over four-bone arthrodesis because of the lower risk of complications. In Kienböck disease, first row carpectomy should only be used for selected patients (Lichtmann III) due to the risk of early degeneration of the capitatum and radius heads.
Collapse
Affiliation(s)
- F Lecomte
- Service d'Orthopédie B, Chirurgie de la main et du membre supérieur, hôpital Roger-Salengro, CHRU de Lille, 59000 Lille.
| | | | | | | | | | | |
Collapse
|
47
|
Lecomte F, Oppenheimer A, Ginsburg C, Dhainaut J, Claessens Y. Computer-assisted prescription improves the delay of morphine infusion after nurse triage in patients admitted in the emergency department with intense pain: a randomized trial. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0993-9857(06)76355-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
48
|
Rozet E, Dewé W, Chiap P, Lecomte F, Hubert P. [The transfer of an automated method for the determination of noradrenaline in human urine: using total error as decision criterion]. Acta Clin Belg 2006; 61 Suppl 1:57-9. [PMID: 16700154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Two new statistical approaches based on the total error of measurements were applied to the transfer of an automated method for the determination of noradrenalin in human urine by LC-ECD coupled on-line to SPE. They showed that the receiving laboratory was mastering the analytical procedure allowing it to use the method in routine. Furthermore the risk based approach gave guarantee that the risk to have future measurements out of specification in the receiving laboratory was smaller than 5%, therefore being a risk management tool.
Collapse
Affiliation(s)
- E Rozet
- Laboratoire de Chimie Analytique, Institut de Pharmacie, Universite de Liège Avenue de l'Hôpital, 1, Bat. B36, 4000 Liege, Belgique.
| | | | | | | | | |
Collapse
|
49
|
Abstract
INTRODUCTION Staphylococcus aureus (SA) has acquired a leading role in nosocomial pneumonia in terms of both frequency and severity, and poses therapeutic problems, namely antibiotic resistance and difficulties in the management of anti-staphylococcal drugs. STATE OF THE ART Epidemiological data confirm that SA is implicated in almost a quarter nosocomial pneumonias, of which about a half are due to methicillin resistant SA (MRSA) in France. The pathophysiology of these infections most often involves inhalation following oropharyngeal carriage. In addition to the risk factors common to all nosocomial pneumonias there are the particular roles of head injury and coma, leading to an increased frequency of SA infection in neuro-surgical patients. PERSPECTIVES The non-specific clinical picture, the grave prognosis of these pneumonias and the ineffectiveness against MRSA of the antibiotics used in the treatment of Gram negative infections make empirical treatment difficult. CONCLUSION In addition to the antibiotics classically active against SA (notably methicillin for sensitive strains and glycopeptides for MRSA) new agents may allow improvement in the treatment of these patients, even if their place is not yet definitively established.
Collapse
Affiliation(s)
- D Benhamou
- Service de Pneumologie Hôpital de Bois-Guillaume, CHU de Rouen, France.
| | | | | |
Collapse
|
50
|
Robaday S, Belizna C, Kerleau JM, Héron F, Cailleux N, Lecomte F, Marie I, Lévesque H. La tuberculose péritonéale : une entité toujours présente. À propos de quatre observations. Rev Med Interne 2005; 26:738-43. [PMID: 15946774 DOI: 10.1016/j.revmed.2005.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Accepted: 05/02/2005] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Tuberculous peritonitis, a major problem in developing country, occurs preferentially in immigrant population and in patients with acquired immune deficiency syndrome (AIDS). Although rare in France, it did not disappear and epidemiological, clinical and therapeutic approach deserve to be reminded. EXEGESIS We reported 4 patients (immigrants in two cases), occurred in caucasian and African persons (one with AIDS). Disease was characterized by fever, abdominal pain, anorexia, weight loss and ascites. Biological and radiological were unconclusive. Cell count analysis from ascitic fluid show a lymphocytic predominance with negative direct smear for Ziehl-Neelsen strain. Tuberculous peritonitis was established with combined visual and histological diagnosic laparoscopic examination. CONCLUSION These observations have the interest to underline that tuberculous peritonitis must be evoked in case of lymphocytic ascitis. We believe an aggressive diagnostic approach, particulary with peritoneal biopsy, is warranted for the diagnosis of tuberculous peritonitis. Validity of PCR amplification is ascitic fluid still needs to be established.
Collapse
Affiliation(s)
- S Robaday
- Département de médecine interne, CHU de Rouen, 76031 Rouen cedex, France
| | | | | | | | | | | | | | | |
Collapse
|