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de la Fouchardière C, Haissaguerre M, Decaussin-Petrucci M, Renaudin K, Deschamps F, Mirallié E, Murez T, Pattou F, Rocher L, Savoie PH, Faron M, Taieb D, Tabarin A, Bertherat J, Gimenez-Roqueplo AP, Amar L, Baudin E, Libé R. [French recommendations for malignant pheochromocytomas and paragangliomas by the national ENDOCAN-COMETE network]. Bull Cancer 2023; 110:1063-1083. [PMID: 37573200 DOI: 10.1016/j.bulcan.2023.06.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/22/2023] [Accepted: 06/05/2023] [Indexed: 08/14/2023]
Abstract
Pheochromocytomas and paragangliomas are rare neuroendocrine tumors, developed respectively in the adrenal medulla and in extra-adrenal locations. Their malignancy is defined by the presence of distant metastases. Forty percent of them are inherited and can be part of different hereditary syndromes. Their management is ensured in France by the multidisciplinary expert centers of the ENDOCAN-COMETE national network "Cancers of the Adrenal gland", certified by the National Cancer Institute and discussed within multidisciplinary team meetings. The diagnostic and therapeutic work-up must be standardized, based on an expert analysis of clinical symptoms, hormonal biological secretions, genetics, morphological and specific metabolic imaging. In the context of a heterogeneous survival sometimes beyond seven to ten years, therapeutic intervention must be justified. This is multidisciplinary and relies on surgery, interventional radiology, external or internal radiotherapy and medical treatments such as sunitinib or dacarbazine and temodal chemotherapy. The personalized approach based on functional imaging fixation status and genetics is progressing despite the extreme rarity of this disease.
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Affiliation(s)
| | - Magalie Haissaguerre
- CHU de Bordeaux, hôpital Haut Lévêque, service d'endocrinologie, centre coordonnateur ENDOCAN-COMETE, Pessac, France
| | | | - Karine Renaudin
- CHU de Nantes, hôpital Hôtel-Dieu, anatomo-pathologie, Nantes, France
| | - Fréderic Deschamps
- Gustave-Roussy Cancer Campus, département de radiologie interventionnelle, Villejuif, France
| | - Eric Mirallié
- CHU de Nantes, hôpital Hôtel-Dieu, chirurgie cancérologique, digestive et endocrinienne, Institut des maladies de l'appareil digestif, Nantes, France
| | - Thibaut Murez
- CHU de Montpellier, département d'urologie et transplantation rénale, Montpellier, France
| | - François Pattou
- CHRU de Lille, département de chirurgie endocrinienne et métabolique, Lille, France
| | - Laurence Rocher
- Université Paris-Saclay, BIOMAPS, hôpital Antoine-Béclère, service de radiologie, Clamart, France
| | - Pierre-Henri Savoie
- Hôpital d'instruction des Armées Sainte-Anne, service d'urologie, Toulon, France
| | - Matthieu Faron
- Gustave-Roussy Cancer Campus, service de chirurgie viscérale oncologique, Villejuif, France
| | - David Taieb
- La Timone University Hospital, CERIMED, Aix-Marseille University, département de médecine nucléaire, Marseille, France
| | - Antoine Tabarin
- CHU de Bordeaux, hôpital Haut Lévêque, service d'endocrinologie, centre coordonnateur ENDOCAN-COMETE, Pessac, France
| | - Jérôme Bertherat
- Hôpital Cochin, CHU de Paris-Centre, service d'endocrinologie, centre coordonnateur ENDOCAN-COMETE, Paris, France
| | | | - Laurence Amar
- Hôpital européen Georges-Pompidou, service d'hypertension artérielle, Paris, France
| | - Eric Baudin
- Gustave-Roussy Cancer Campus, service de cancérologie endocrine, centre coordonnateur ENDOCAN-COMETE, Villejuif, France
| | - Rossella Libé
- Hôpital Cochin, CHU de Paris-Centre, service d'endocrinologie, centre coordonnateur ENDOCAN-COMETE, Paris, France.
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Galeotti C, Bajolle F, Belot A, Biscardi S, Bosdure E, Bourrat E, Cimaz R, Darbon R, Dusser P, Fain O, Hentgen V, Lambert V, Lefevre-Utile A, Marsaud C, Meinzer U, Morin L, Piram M, Richer O, Stephan JL, Urbina D, Kone-Paut I. French national diagnostic and care protocol for Kawasaki disease. Rev Med Interne 2023:S0248-8663(23)00647-1. [PMID: 37349225 DOI: 10.1016/j.revmed.2023.06.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/04/2023] [Indexed: 06/24/2023]
Abstract
Kawasaki disease (KD) is an acute vasculitis with a particular tropism for the coronary arteries. KD mainly affects male children between 6 months and 5 years of age. The diagnosis is clinical, based on the international American Heart Association criteria. It should be systematically considered in children with a fever, either of 5 days or more, or of 3 days if all other criteria are present. It is important to note that most children present with marked irritability and may have digestive signs. Although the biological inflammatory response is not specific, it is of great value for the diagnosis. Because of the difficulty of recognising incomplete or atypical forms of KD, and the need for urgent treatment, the child should be referred to a paediatric hospital as soon as the diagnosis is suspected. In the event of signs of heart failure (pallor, tachycardia, polypnea, sweating, hepatomegaly, unstable blood pressure), medical transfer to an intensive care unit (ICU) is essential. The standard treatment is an infusion of IVIG combined with aspirin (before 10 days of fever, and for a minimum of 6 weeks), which reduces the risk of coronary aneurysms. In case of coronary involvement, antiplatelet therapy can be maintained for life. In case of a giant aneurysm, anticoagulant treatment is added to the antiplatelet agent. The prognosis of KD is generally good and most children recover without sequelae. The prognosis in children with initial coronary involvement depends on the progression of the cardiac anomalies, which are monitored during careful specialised cardiological follow-up.
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Affiliation(s)
- C Galeotti
- Service de rhumatologie pédiatrique, centre de référence des maladies auto-inflammatoires rares et des amyloses, CHU de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
| | - F Bajolle
- M3C-Necker-Enfants-Malades, hôpital Necker-Enfants-Malades, université de Paris Cité, Paris, France
| | - A Belot
- Service de néphrologie, rhumatologie et dermatologie pédiatriques, centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant (RAISE), hôpital Femme-Mère-Enfant, hospices civils de Lyon, Lyon, France
| | - S Biscardi
- Service des urgences pédiatriques, centre hospitalier intercommunal de Créteil, Créteil, France
| | - E Bosdure
- Service de spécialités pédiatriques et médecine infantile, CHU Timone-Enfants, 13385 Marseille cedex 5, France
| | - E Bourrat
- Service de pédiatrie générale, maladies infectieuses et médecine interne, centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant, hôpital universitaire Robert-Debré, université hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - R Cimaz
- Pediatric Rheumatology Unit, Gaetano Pini Hospital, Department of Clinical Sciences and Community Health, Research Centre for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
| | - R Darbon
- Association France vascularites, Blaisy-Bas, France
| | - P Dusser
- Service de rhumatologie pédiatrique, centre de référence des maladies auto-inflammatoires rares et des amyloses, CHU de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
| | - O Fain
- Service de médecine interne, hôpital Saint-Antoine, Sorbonne université, AP-HP, 75012 Paris, France
| | - V Hentgen
- Service de pédiatrie, centre de référence des maladies auto-inflammatoires et de l'amylose (CEREMAIA), centre hospitalier de Versailles, Le Chesnay, France
| | - V Lambert
- Service de radiologie pédiatrique, Institut mutualiste Montsouris, CHU de Bicêtre, Le Kremlin-Bicêtre, France
| | - A Lefevre-Utile
- Service de pédiatrie générale et des urgences pédiatriques, hôpital Jean-Verdier, Assistance publique-Hôpitaux de Paris (AP-HP), Bondy, France
| | - C Marsaud
- Service de rhumatologie pédiatrique, centre de référence des maladies auto-inflammatoires rares et des amyloses, CHU de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
| | - U Meinzer
- Service de pédiatrie générale, maladies infectieuses et médecine interne, centre de référence des rhumatismes inflammatoires et maladies auto-immunes systémiques rares de l'enfant, hôpital universitaire Robert-Debré, université hospital, Assistance publique-Hôpitaux de Paris, 75019 Paris, France
| | - L Morin
- Service de réanimation pédiatrique et néonatale, DMU 3 santé de l'enfant et adolescent, hôpital Bicêtre, université Paris-Saclay, AP-HP, Le Kremlin-Bicêtre, France
| | - M Piram
- Division of Dermatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte Justine, Université de Montréal, Montréal, Quebec, Canada
| | - O Richer
- Service des urgences pédiatriques, hôpital universitaire de Pellegrin, Bordeaux, France
| | - J-L Stephan
- Service de pédiatrie, CHU Saint-Étienne, Saint-Étienne, France
| | - D Urbina
- Service d'accueil des urgences pédiatriques, hôpital Nord, AP-HM, 13005 Marseille, France
| | - I Kone-Paut
- Service de rhumatologie pédiatrique, centre de référence des maladies auto-inflammatoires rares et des amyloses, CHU de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France
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Libé R, Haissaguerre M, Renaudin K, Faron M, Decaussin-Petrucci M, Deschamps F, Gimenez-Roqueplo AP, Mirallie E, Murez T, Pattou F, Rocher L, Taïeb D, Savoie PH, Tabarin A, Bertherat J, Baudin E, de la Fouchardière C. [Guidelines of the French National ENDOCAN-COMETE, Association of Endocrine Surgery, Society of Urology for the management of adrenocortical carcinoma]. Bull Cancer 2023; 110:707-730. [PMID: 37061367 DOI: 10.1016/j.bulcan.2023.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/26/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 04/17/2023]
Abstract
The adrenocortical carcinoma (ACC) is a primary malignant tumor developed from the adrenal cortex, defined by a Weiss score≥3. Its prognosis is poor and depends mainly on the stage of the disease at diagnosis. Care is organized in France by the multidisciplinary expert centers of the national ENDOCAN-COMETE "Adrenal Cancers" network, certified by the National Cancer Institute. This document updates the guidelines for the management of ACC in adults based on the most robust data in the literature. It's divided into 11 chapters: (1) circumstances of discovery; (2) pre-therapeutic assessment; (3) diagnosis of ACC; (4) oncogenetics; (5) prognostic classifications; (6) treatment of hormonal hypersecretion; (7) treatment of localized forms; (8) treatment of relapses; (9) treatment of advanced forms; (10) follow-up; (11) the particular case of ACC and pregnancy. R0 resection of all localized ACC remains an unmet need and it must be performed in expert centers. Flow-charts for the therapeutic management of localized ACC, relapse or advanced ACC are provided. It was written by the experts from the national ENDOCAN-COMETE network and validated by all French Societies involved in the management of these patients (endocrinology, medical oncology, endocrine surgery, urology, pathology, genetics, nuclear medicine, radiology, interventional radiology).
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Affiliation(s)
- Rossella Libé
- CHU Paris Centre, hôpital Cochin, centre coordonnateur ENDOCAN-COMETE, service d'endocrinologie, Paris, France.
| | - Magalie Haissaguerre
- CHU de Bordeaux, hôpital Haut-Lévêque, centre coordonnateur ENDOCAN-COMETE, service d'endocrinologie, Pessac, France
| | - Karine Renaudin
- CHU de Nantes, hôpital Hôtel-Dieu, service d'anatomie pathologique, Nantes, France
| | - Matthieu Faron
- Gustave-Roussy Cancer Campus, service de chirurgie viscérale oncologique, Villejuif, France
| | | | - Fréderic Deschamps
- Gustave-Roussy Cancer Campus, département de radiologie interventionnelle, Villejuif, France
| | | | - Eric Mirallie
- CHU de Nantes, hôpital Hôtel-Dieu, institut des maladies de l'appareil digestif, chirurgie cancérologique, digestive et endocrinienne, Nantes, France
| | - Thibaut Murez
- CHU de Montpellier, département d'urologie et transplantation rénale, Montpellier, France
| | - François Pattou
- CHRU de Lille, département de chirurgie endocrinienne et métabolique, Lille, France
| | - Laurence Rocher
- Hôpitaux et université Paris Saclay, hôpital Antoine-Béclère, service de radiologie, Clamart, France
| | - David Taïeb
- La Timone University Hospital, Aix-Marseille University, CERIMED, département de médecine nucléaire, Marseille, France
| | - Pierre Henri Savoie
- Hôpital d'instruction des Armées Sainte-Anne, service d'urologie, Toulon, France
| | - Antoine Tabarin
- CHU de Bordeaux, hôpital Haut-Lévêque, centre coordonnateur ENDOCAN-COMETE, service d'endocrinologie, Pessac, France
| | - Jérôme Bertherat
- CHU Paris Centre, hôpital Cochin, centre coordonnateur ENDOCAN-COMETE, service d'endocrinologie, Paris, France
| | - Eric Baudin
- Gustave-Roussy Cancer Campus, centre coordonnateur ENDOCAN-COMETE, service de cancérologie endocrine, Villejuif, France
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Soorojebally Y, Neuzillet Y, Lebret T, Allory Y, Descotes F, Ferlicot S, Kassab-Chahmi D, Lamy PJ, Oudard S, Rébillard X, Roy C, Roumiguié M, Rouprêt M, Audenet F. Photodynamic cystoscopy for bladder cancer diagnosis and for NMIBC follow-up: An overview of systematic reviews and meta-analyses. Prog Urol 2023; 33:307-318. [PMID: 37088584 DOI: 10.1016/j.purol.2023.03.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/07/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Currently, bladder cancer detection is based on cytology and cystoscopy. White light cystoscopy (WLC) is an invasive procedure and may under-detect flat lesions. Blue light cystoscopy (BLC) and narrow band imaging (NBI) cystoscopy are new modalities that could improve the detection of non-muscle invasive bladder cancer (NMIBC) and its recurrence or progression to muscle invasive bladder cancer. We present a systematic review on BLC and NBI cystoscopy for bladder cancer diagnosis and NMIBC follow-up. MATERIAL AND METHODS All available systematic reviews and meta-analyses on cystoscopy published in PubMed® between May 2010 and March 2021 were identified and reviewed. The main endpoints were clinical performance for bladder cancer diagnosis and for recurrence or progression detection during NMIBC follow-up, and additional value compared with cytology and/or WLC. RESULTS Most of the meta-analyses and systematic reviews published suggest a better sensitivity of BLC and NBI cystoscopy compared to WLC, particularly for the detection of flat lesions (CIS). NBI- and BLC-guided TURBT could decrease the recurrence rates. However, their clinical utility to reduce progression rate and increase survival is still unclear. CONCLUSIONS BLC and NBI cystoscopy are efficient techniques for bladder cancer diagnosis and NMIBC follow-up. However, their clinical benefit remains to be confirmed.
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Affiliation(s)
- Y Soorojebally
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Y Neuzillet
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - T Lebret
- Department of urology, Foch Hospital, Paris Saclay University, Suresnes, France
| | - Y Allory
- Department of pathology, Institut Curie, Saint-Cloud, France
| | - F Descotes
- Biochemistry, biology and pathology centre South, Hospices civils de Lyon (HCL), Université Claude-Bernard Lyon I, Pierre-Bénite, France
| | - S Ferlicot
- Service d'anatomie pathologique, Hôpital de Bicêtre, AP-HP, Le Kremlin Bicêtre, France
| | | | - P-J Lamy
- Biopathologie et génétique des cancers, Institut médical d'analyse génomique, Imagenome, Inovie, Montpellier, France
| | - S Oudard
- Department of medical oncology, Hôpital européen Georges-Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France
| | - X Rébillard
- Urology Department, Beausoleil Private Hospital, Montpellier, France
| | - C Roy
- Department of radiology B, Strasbourg University Hospital - New Civil Hospital, Strasbourg, France
| | - M Roumiguié
- Department of urology, andrology and renal transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse cedex, France
| | - M Rouprêt
- Sorbonne University, GRC 5 predictive Onco-Uro, Urology, Pitié-Salpêtrière Hospital, AP-HP, 75013 Paris, France
| | - F Audenet
- Department of urology, Hôpital européen Georges-Pompidou, AP-HP.Centre, Université Paris Cité, Paris, France.
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Dégot T, Douvry B, Falque L, Bautin N, Frachon I, Mankikian J, Le Pavec J, Picard C. [Follow-up strategies for lung transplant recipients in France]. Rev Mal Respir 2023; 40:314-323. [PMID: 36868975 DOI: 10.1016/j.rmr.2023.01.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/24/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Lung transplantation (LT) requires sustained care for a frequently polypathological condition. Follow-up is focused on three main issues: 1/stability of respiratory function; 2/comorbidity management; 3/preventive medicine. About 3000 LT patients in France are treated in 11 LT centers. Given the increased size of the LT recipient cohort, follow-up might be partially shared with peripheral centers. METHODS This paper presents the suggestions of a working group of the SPLF (French-speaking respiratory medicine society) on possible modalities of shared follow-up. RESULTS While the main LT center is tasked with centralizing follow-up, particularly the choice of optimal immunosuppression, an identified peripheral center (PC) may serve as an alternative to deal with acute events, comorbidities and routine assessment. Communication between the different centers should be free-flowing. Shared follow-up may be offered from the 3rd postoperative year to stable and consenting patients, whereas unstable and non-observant patients are poor candidates. CONCLUSION These guidelines may serve as a reference for any pneumologist wishing to effectively contribute to follow-up, even and especially subsequent to lung transplant.
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Affiliation(s)
- T Dégot
- Groupe de transplantation pulmonaire, service de pneumologie, hôpitaux universitaires de Strasbourg, nouvel hôpital Civil, Strasbourg, France.
| | - B Douvry
- Service de pneumologie, centre hospitalier intercommunal, centre des maladies respiratoires rares (RESPIRARE®), CRCM, Créteil, France; Inserm, IMRB, université Paris-Est Créteil, 94010 Créteil, France
| | - L Falque
- Pôle thorax et vaisseaux, service hospitalier universitaire pneumologie physiologie, CHU de Grenoble-Alpes, Grenoble, France
| | - N Bautin
- Inserm, CHU de Lille, université de Lille, CNRS, institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - I Frachon
- Service de pneumologie, CHU, hôpital Cavale Blanche, Brest, France
| | - J Mankikian
- Service de pneumologie et d'explorations fonctionnelles respiratoires, CHU, hôpital Bretonneau, Tours, France
| | - J Le Pavec
- Service de pneumologie et transplantation pulmonaire, groupe hospitalier Marie-Lannelongue - Saint-Joseph, Le Plessis-Robinson, France; Université Paris-Saclay, Le Kremlin-Bicêtre, France; Inserm, UMR_S 999, université Paris-Sud, groupe hospitalier Marie-Lannelongue - Saint-Joseph, Le Plessis-Robinson, France
| | - C Picard
- Groupe de transplantation pulmonaire, service de pneumologie, hôpital Foch, Suresnes, France
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Bouras S. [Is the UISS score suitable for the postoperative follow-up protocol for kidney cancer?]. Prog Urol 2023; 33:48-49. [PMID: 36153221 DOI: 10.1016/j.purol.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023]
Affiliation(s)
- S Bouras
- Département d'urologie, faculté de médecine, université Ferhat Abbas 1, CHU de Sétif, Algérie.
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Brenot G, Dominique I, Peyronnet B, Savoie PH, Chiron P; Groupe collaboratif TraumAFUF. [Late complications after blunt renal trauma: A French multicenter study]. Prog Urol 2022:S1166-7087(21)00581-9. [PMID: 34998680 DOI: 10.1016/j.purol.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/25/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Among genitourinary traumas, blunt trauma to the kidney are the most frequent: their initial management has been well studied but their development at a distance is poorly documented. The objective of this study was to assess the late complications of blunt renal trauma, and to investigate their predictive factors for occurrence. MATERIALS AND METHODS A retrospective observational study of the TraumAFUF project was conducted, including, between 2005 and 2018, all blunt renal trauma treated in 18 French hospitals and followed for more than 3 months. The characteristics of the initial trauma, as well as any complications occurring after three months, were identified. The patients were divided into two groups: onset of a late complication (LC) or uncomplicated (UC). The groups were compared in univariate and multivariate analyses to identify the risk factors for the occurrence of these complications. RESULTS Among the 454 patients included, 50 presented with LC (11%), as symptomatic morphologically altered kidney (2.9%), secondarily impaired biological renal function (2.9%), or secondary arterial hypertension (2.4%). The risk factors identified were, during initial medical care, a high-grade renal trauma≥IV (OR=2.4, P=0.025), active bleeding (OR=2.6, P=0.007), the need for transfusion (OR=2.3, P=0.001), or interventional (R=1.7, P=0.09) or endoscopic treatment (OR=2.0, P=0.035). CONCLUSION In this study, late complications occurred in 11% of cases after blunt renal trauma. The risk factors identified make it possible to draw up a patient profile who would benefit from prolonged follow-up to detect these complications. LEVEL OF EVIDENCE 3.
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Abstract
The purpose of this article is to describe the external irradiation process and updated recommendations of the French society for radiation oncology for patient follow-up.
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Affiliation(s)
- I Barillot
- Hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France; Université François-Rabelais, 10, boulevard Tonnellé, 37000 Tours, France.
| | - D Azria
- Fédération universitaire d'oncologie radiothérapie Forom, Institut régional du cancer Montpellier (ICM), université de Montpellier, rue Croix-Verte, 34298 Montpellier cedex 05, France; Institut de recherche en cancérologie de Montpellier (IRCM), Inserm U1194, INCa, DGOS_12553, université de Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France
| | - A Lisbona
- Centre René-Gauducheau, Institut de cancérologie de l'ouest, boulevard Jacques-Monod, 44800 Saint-Herblain, France
| | - M-A Mahé
- Centre François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
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Abstract
INTRODUCTION Physical activity in daily life (PA) in patients with chronic respiratory disease is reduced. Inactivity is associated with an increased risk of hospitalisation and mortality. Even though pulmonary rehabilitation (PR) is associated with improved quality of life (fewer symptoms, greater exercise capacity…), its benefits with regard to PA remain unclear. STATE OF THE ART For each patient, it is important during a respiratory rehabilitation (RR) programme to evaluate PA and its determinants. Only programs aimed at improved self-management and including educational therapy (ETP) have shown a short-term increase of PA following PR. Several studies have reported better long-term adherence when professionals help the patient to construct a personalised PA project, with regular follow-up and an array of activities (local facilities, urban walking…) chosen by the patient and adapted to the environment. PERSPECTIVES The ongoing SARS-CoV2 pandemic has highlighted the importance of human interaction, even at a distance using information and communication technologies, as a means of sustaining patient motivation. Future controlled and randomized studies should focus on the long-term impact on PA of innovative strategies in patients with chronic respiratory diseases. Moreover, it would be interesting to quantify the socioeconomic impact as well as the sustainable health benefits of the different strategies outlined in this review. CONCLUSION It is not possible to offer a single solution likely to maintain RR benefits over an extended lapse of time. However, follow-up with an ETP and/or regular and customized support during the post-training period facilitates the long-term adoption of active behavior.
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Affiliation(s)
- B Chéhère
- Université de Bretagne Occidentale, EA4324, laboratoire ORPhy, faculté des sciences du sport et de l'éducation, Brest, France.
| | - J Pernot
- Centre de réadaptation respiratoire, centre hospitalier Métropole Savoie, Aix-les-Bains, France
| | - F Costes
- Université Clermont Auvergne, unité de nutrition humaine, service de médecine du sport et explorations fonctionnelles, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Abstract
INTRODUCTION The purpose of monitoring a patient treated for overactive bladder (OAB) is to ensure the effectiveness of the treatment and to detect any side effects. OBJECTIVE To synthesize current knowledge on the follow-up and the evaluation of non-neurogenic OAB treatments. METHOD A systematic literature review based on Pubmed, Embase, Google Scholar was conducted in June 2020. RESULTS The definition of success of OAB treatments is not consensual. Definitions of success in clinical trials usually use bladder diary data. However, they cannot always be transposed into clinical practice because they do not measure the overall effectiveness of a treatment, reported by the patient, or the satisfaction with the treatment. It is then necessary to have symptom questionnaires with an assessment of quality of life. Indeed, the concept of therapeutic success is different depending on the view of the physician or the patient. It is therefore important to carefully assess with the patient, and before initiating any treatment, the objectives and expected results of the treatment. The definition of "refractory" OAB is heterogeneous but important to select candidates for second-line treatments. Monitoring a patient with OAB is essential to adapt the treatment to efficacy and tolerance, but also to detect any change in symptoms that may reveal another urological disease. CONCLUSION The success or failure of OAB treatments depends on the interaction of many factors, including objective criteria measured by the clinician, and subjective criteria of perception of the treatment effectiveness by the patient.
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Affiliation(s)
- V Phé
- Service d'urologie, hôpital Pitié-Salpêtrière, AP-HP Sorbonne université, Paris, France.
| | - X Gamé
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, université Paul-Sabatier, Toulouse, France
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du Boulet B, Bringer-Deutsch S, Anahory T, Ferrières A, Loup Cabaniols V, Duraes M, Huberlant S, Ranisavljevic N. [Oncofertility and breast cancer at Montpellier University Hospital: Retrospective analysis of patients management since 2011]. ACTA ACUST UNITED AC 2020; 49:112-121. [PMID: 33130043 DOI: 10.1016/j.gofs.2020.10.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Five to 7% of breast cancers affect women under 40 years old. The survival of these patients has been improved thanks to therapeutic advances, often to the detriment of their fertility. The objective of this study is to evaluate the activity of oncofertility and the future of young women with breast cancer managed at the Montpellier University Hospital. METHODS This is a retrospective study including women aged from 18 to 43 years-old diagnosed with breast cancer and referred in oncofertility consultation at the Montpellier University Hospital between July 2011 and December 2018. RESULTS 190 patients were eligible, three refused to participate to the study, hence 187 patients were included. We estimate that only 33% of young breast cancer patients potentially eligible for fertility preservation (FP) benefited from an oncofertility consultation in our region. Of these 187 patients, 58 (31%) underwent ovarian stimulation for oocyte or embryo vitrification. They were significantly younger: 32.9 vs 34.6 years old (P=0.01) and had fewer invaded lymph nodes. A total of 66 cycles were achieved and 11.4 oocytes or 3 embryos were vitrified per patient. The reuse rate was 3.6% with 91% of post cancer pregnancies being spontaneous. CONCLUSION The oncofertility care network seems effective at the regional level. Enhancing health professionals' awareness and creating a regional register could improve our long-term follow-up.
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Affiliation(s)
- B du Boulet
- Service de gynécologie obstétrique et médecine de la reproduction, pole naissance et pathologie de la femme, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
| | - S Bringer-Deutsch
- Service de gynécologie obstétrique et médecine de la reproduction, pole naissance et pathologie de la femme, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France.
| | - T Anahory
- Service de gynécologie obstétrique et médecine de la reproduction, pole naissance et pathologie de la femme, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
| | - A Ferrières
- Service de biologie de la reproduction, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
| | - V Loup Cabaniols
- Service de biologie de la reproduction, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
| | - M Duraes
- Service de gynécologie obstétrique et médecine de la reproduction, pole naissance et pathologie de la femme, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
| | - S Huberlant
- Service de gynécologie obstétrique et médecine de la reproduction, centre hospitalier universitaire de Nîmes, place du Professeur Robert-Debré, 30029 Nîmes cedex 9, France
| | - N Ranisavljevic
- Service de gynécologie obstétrique et médecine de la reproduction, pole naissance et pathologie de la femme, centre hospitalier universitaire Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34090 Montpellier cedex 5, France
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12
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Duroi Q, Leclerc C, Chardon JF, Le Lez ML, Khanna RK, Pisella PJ. [Screening for diabetic retinopathy in the Centre-Val de Loire region: A study based on the French national healthcare database]. J Fr Ophtalmol 2020; 43:1054-1061. [PMID: 33059944 DOI: 10.1016/j.jfo.2020.01.030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 01/23/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The main objective of this study was to investigate the rate of ophthalmological screening for diabetic retinopathy in diabetic individuals in the Centre-Val de Loire (CVDL) region. This study secondarily aimed to identify factors associated with regular ophthalmological screening. MATERIAL AND METHODS Data were extracted from the French national healthcare database (SNDS). Individuals were identified on the basis of reimbursements for antidiabetic medications. Patients who were identified as having at least one reimbursed eye examination between 2015 and 2016 were considered as having regular follow-up. RESULTS In total, 118,181 diabetic individuals residing in CVDL were identified in the SNDS, and 74,048 had undergone ophthalmological screening. The rate of eye examination was 62.7% between 2015 and 2016 and was highly variable within the region (from 65.6% in Loiret to 54.0% in Cher). The main factors associated with regular eye screening were: follow-up with an established primary care physician (OR=2.88), regular follow-up with a diabetologist (OR=2.14), and regular follow-up with an internist (OR=1.57). CONCLUSION This study suggests that ophthalmological screening for diabetic retinopathy in individuals with diabetes in the CVDL region could be significantly improved, particularly in rural areas. Factors influencing compliance with follow-up are multiple but appear mainly related to the patients' quality of overall medical management. These findings highlight the need for public health policies to improve detection and prevention of diabetic retinopathy by promoting comprehensive medical care for diabetic individuals.
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Affiliation(s)
- Q Duroi
- Service d'ophtalmologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France.
| | - C Leclerc
- Observatoire régionale de la santé du Centre-Val de Loire, 1, bis rue porte Madeleine, 45000 Orléans, France
| | - J-F Chardon
- Direction régionale du service médical Centre-Val de Loire, 25, boulevard Jean-Jaurès, 45016 Orléans cedex 1, France
| | - M-L Le Lez
- Service d'ophtalmologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - R K Khanna
- Service d'ophtalmologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - P-J Pisella
- Service d'ophtalmologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
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Decazes P, Thureau S, Modzelewski R, Damilleville-Martin M, Bohn P, Vera P. Benefits of positron emission tomography scans for the evaluation of radiotherapy. Cancer Radiother 2020; 24:388-397. [PMID: 32448741 DOI: 10.1016/j.canrad.2020.02.007] [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: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 12/23/2022]
Abstract
The assessment of tumour response during and after radiotherapy determines the subsequent management of patients (adaptation of treatment plan, monitoring, adjuvant treatment, rescue treatment or palliative care). In addition to its role in extension assessment and therapeutic planning, positron emission tomography combined with computed tomography provides useful functional information for the evaluation of tumour response. The objective of this article is to review published data on positron emission tomography combined with computed tomography as a tool for evaluating external radiotherapy for cancers. Data on positron emission tomography combined with computed tomography scans acquired at different times (during, after initial and after definitive [chemo-]radiotherapy, during post-treatment follow-up) in solid tumours (lung, head and neck, cervix, oesophagus, prostate and rectum) were collected and analysed. Recent recommendations of the National Comprehensive Cancer Network are also reported. Positron emission tomography combined with computed tomography with (18F)-labelled fluorodeoxyglucose has a well-established role in clinical routine after chemoradiotherapy for locally advanced head and neck cancers, particularly to limit the number of neck lymph node dissection. This imaging modality also has a place for the evaluation of initial chemoradiotherapy of oesophageal cancer, including the detection of distant metastases, and for the post-therapeutic evaluation of cervical cancer. Several radiotracers for positron emission tomography combined with computed tomography, such as choline, are also recommended for patients with prostate cancer with biochemical failure. (18F)-fluorodeoxyglucose positron emission tomography combined with computed tomography is optional in many other circumstances and its clinical benefits, possibly in combination with MRI, to assess response to radiotherapy remain a very active area of research.
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Affiliation(s)
- P Decazes
- Département de médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; QuantIF-Litis, EA 4108, faculté de médecine, université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France.
| | - S Thureau
- Département de médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; QuantIF-Litis, EA 4108, faculté de médecine, université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France; Département de radiothérapie et de physique médicale, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - R Modzelewski
- Département de médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; QuantIF-Litis, EA 4108, faculté de médecine, université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France
| | - M Damilleville-Martin
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - P Bohn
- Département de médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; QuantIF-Litis, EA 4108, faculté de médecine, université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France
| | - P Vera
- Département de médecine nucléaire, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France; QuantIF-Litis, EA 4108, faculté de médecine, université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France
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Andrejak C, Blanc FX, Costes F, Crestani B, Debieuvre D, Perez T, Philippe B, Plantier L, Schlemmer F, Sesé L, Stach B, Uzunhan Y, Zanetti C, Zysman M, Raherison C, Maitre B. [Guide for follow-up of patients with SARS-CoV-2 pneumonia. Management proposals developed by the French-language Respiratory Medicine Society. Version of 10 May 2020]. Rev Mal Respir 2020; 37:505-10. [PMID: 32410773 DOI: 10.1016/j.rmr.2020.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
La Société de pneumologie de langue française propose un guide pour le suivi respiratoire des patients ayant présenté une pneumonie à SARS-CoV-2 à partir des données connues des précédentes épidémies, des lésions aiguës constatées chez ces patients et d’opinions d’experts. Ce guide propose une conduite à tenir selon le type de patients : (1) patient pris en charge en ville pour une infection à SARS-CoV-2 possible ou prouvée adressé par son médecin traitant pour dyspnée persistante, (2) patient hospitalisé pour pneumonie à SARS-CoV-2 en unité conventionnelle, (3) patient hospitalisé pour pneumonie à SARS-CoV-2 ayant fait un séjour en réanimation. Le suivi ultérieur sera à adapter au bilan initial. Ce guide insiste sur le fait qu’il ne faut pas méconnaître les autres causes de dyspnée (cardiaques, thromboemboliques, syndrome d’hyperventilation, …). Ces propositions pourront évoluer dans le temps au fil des connaissances sur le sujet.
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15
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Lepart C, Ardois S, Bismut M, Ballerie A, Cazalets C, Coiffier G, Jego P, Belhomme N, Lescoat A. [Illnesses unrelated to systemic sclerosis (IUSS) diagnosed throughout the patient's follow-up in a referral center: A cohort of 200 patients]. Rev Med Interne 2020; 41:517-22. [PMID: 32354573 DOI: 10.1016/j.revmed.2020.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/22/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Our work aimed to investigate the illnesses unrelated to systemic sclerosis (IUSS), diagnosed among patients with systemic sclerosis (SSc) throughout their follow-up in a referral tertiary care center. METHODS All the patients with SSc followed in the Internal Medicine Department of the University Hospital between October, 2014 and December, 2015, were included. We specifically reviewed the medical records of the patients who exhibited IUSS, defined as an illness that could not be considered as a typical clinical manifestation or as a usual complication of the disease. RESULTS Two hundred patients were included, and 38 IUSS were diagnosed among 31 SSc patients, over a 4 years median follow-up period. These diagnoses included vascular diseases (26%), heart diseases (21%), neoplasia (8%), infectious diseases (6%), autoimmune diseases (5%), endocrinopathies (5%), and others (24%). The median follow-up time before IUSS diagnosis was two years. Seventeen (45%) of these diagnoses were considered in patients showing suggestive clinical signs. A specific therapy was delivered in 25 cases (66%). Group comparisons revealed that dyslipidemia was more frequent in patients with IUSS (OR = 2.6 [1.1-1.5]; p = 0.014), while no differences were found for the other characteristics. Especially, no association between auto-antibodies specificity and the occurrence of IUSS was found. CONCLUSION This study focused on IUSS in SSc patients and highlights the need for a polyvalent clinical approach all along the follow up of SSc patients.
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16
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Ikobo LCO, Mberi FDM, Nika ER, Mandilou SVM, Ngoulou BSA, Loufoua ABM, Mabiala-Babela JR. [Evaluation of the Follow-Up and State of Adolescents with Sickle-Cell Disease in Brazzaville (Congo)]. ACTA ACUST UNITED AC 2020; 112:213-219. [PMID: 32003198 DOI: 10.3166/bspe-2019-0097] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 10/31/2019] [Indexed: 11/20/2022]
Abstract
The experience of the adolescent with homozygous sickle-cell disease is influenced by several factors that differentiate it from the older child entirely dependent on his parents. The objective of this study was to describe the state of health and to assess the quality of follow-up and to identify the determinants of poor monitoring of adolescent sickle-cell followed in Brazzaville for an average of 12 ± 9.6 years, starting from a cross-sectional study carried out at the Brazzaville University Hospital from March to September 2016. It is based on a questionnaire composed of elements of assessment of the state of health and the quality of the follow-up. The vaccination coverage of adolescents was low, 81.3% for DTCP, 66.5% for Typhim Vi, 50.2% for viral hepatitis B, 76.4% for pneumococcus, and 59.1% for the ROR. In the last two years prior to the survey, 99 (48.7%) adolescents had only 2 follow-up visits instead of 4 planned per year. Therapeutic compliance was good in 132 (65%). No hospitalizations were reported during this period in 23 adolescents (11.3%); in 180 cases (88.7%), however, adolescents were hospitalized one to three times apart from regular follow-up visits. Since the discovery of the disease, 177 (87.2%) adolescents had already been transfused, more than three times in 89 cases. A history of neurovascular seizures was found in 10 cases (5.2%) and priapism in 35 cases (18.2%). Paraclinical examinations were not systematic during follow-up visits. The socioeconomic level of the family and the level of education of the father had a negative impact on monitoring and adherence (P < 0.01). On clinical examinations, stunting, undernutrition, pubertal delay, tooth decay, enuresis were found in 45.3%, 36%, 53.7%, 27.6%, 15.3%, respectively. The biological examinations carried out during the investigation showed an average inter-critical hemoglobin level between 7 and 8 g/dl, creatinine level was normal in all cases, ferritinemia was elevated in 93.6%, a negative proteinuria was found in 71.4% of the cases, and hematuria in 26.6%. Systematic abdominal ultrasound revealed vesicular lithiasis in 8 cases, hepatomegaly in 10 cases, and splenomegaly in 102 cases. Echocardiography performed in all subjects showed cardiomyopathy in 9 cases. The follow-up of the adolescent sickle-cell in Brazzaville still faces enormous difficulties. The improvement of the standard of living, the therapeutic education and the introduction of a total free of charge of the global management of sickle-cell disease would make it possible to minimize these difficulties which also would improve the future of these teenagers, adults of tomorrow.
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Affiliation(s)
- L C Ollandzobo Ikobo
- Faculté des sciences de la santé, université Marien-Ngouabi de Brazzaville, Congo.,Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - F D Mouyabi Mberi
- Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - E R Nika
- Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - S V Missambou Mandilou
- Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - B S A Ngoulou
- Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - A B M'Pemba Loufoua
- Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
| | - J R Mabiala-Babela
- Faculté des sciences de la santé, université Marien-Ngouabi de Brazzaville, Congo.,Service de pédiatrie-nourrissons, centre hospitalier et universitaire de Brazzaville, Congo
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Tetart M, Meybeck A, Assaf A, Valette M, Choisy P, Blondiaux N, Senneville E. Factors of loss to follow-up during tuberculosis treatment in a low-incidence region. Med Mal Infect 2019; 50:28-35. [PMID: 30890281 DOI: 10.1016/j.medmal.2019.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/03/2018] [Accepted: 02/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The proportion of successfully treated tuberculosis (TB) patients remains below the WHO target in France, because of a high proportion of loss to follow-up. We aimed to identify factors associated with loss to follow-up in northern France, a low-incidence area. METHODS Between 1997 and 2017, all consecutive patients diagnosed with TB at the Tourcoing Hospital, except those infected with multidrug-resistant or extensively drug-resistant strains, were included in a retrospective cohort study. A logistic regression analysis was performed to determine factors associated with loss to follow-up. RESULTS One hundred and ninety patients were included. Previous TB treatment was reported in 32 patients (17%), extrapulmonary TB in 107 (56%), and HIV infection in 44 (23%). The proportion of loss to follow-up was 15%. In multivariate analysis, the risk of loss to follow-up decreased in case of first TB treatment (OR 0.36; 95% CI: 0.14-0.92, P=0.03) and increased in non-HIV-infected patients (OR 7.67; 95% CI: 1.00-59.0, p=0.05). Support for compliance was more frequent in HIV-infected patients (23% vs. 7%, p=0.005). CONCLUSION The proportion of loss to follow-up was high. HIV infection was associated with a lower risk of loss to follow-up, likely to be due to more frequent support for compliance.
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Affiliation(s)
- M Tetart
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France
| | - A Meybeck
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France.
| | - A Assaf
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France
| | - M Valette
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France
| | - P Choisy
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France
| | - N Blondiaux
- Laboratoire de microbiologie, centre hospitalier Dron, 59200 Tourcoing, France
| | - E Senneville
- Service des maladies infectieuses, centre hospitalier Dron, 135, avenue du Président-Coty, 59200 Tourcoing, France
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Brun JL, Castan B, de Barbeyrac B, Cazanave C, Charvériat A, Faure K, Mignot S, Verdon R, Fritel X, Graesslin O. [Pelvic Inflammatory Diseases: Updated Guidelines for Clinical Practice - Short version]. ACTA ACUST UNITED AC 2019; 47:398-403. [PMID: 30880245 DOI: 10.1016/j.gofs.2019.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To provide up-to-date guidelines on management of pelvic inflammatory disease (PID). METHODS An initial search of the Cochrane database, PubMed, and Embase was performed using keywords related to PID to identify reports in any language published between January 1990 and January 2012, with an update in 2018. All identified reports published in French and English relevant to the areas of focus were included. A level of evidence based on the quality of the data available was applied for each area of focus and used for the guidelines. RESULTS PID must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to exclude tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1g, once, by intra-muscular (IM) or intra-venous (IV) route, doxycycline 100mg×2/d, and metronidazole 500mg×2/d oral (PO) for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1 to 2g/d until clinical improvement, doxycycline 100mg×2/d, IV or PO, and metronidazole 500mg×3/d, IV or PO for 14days (grade B). Drainage of TOA is indicated if the collection measures more than 3cm (grade B). Follow-up is required in women with sexually transmitted infections (STI) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3 to 6months after PID (grade C), before the insertion of an intra-uterine device (grade B), before elective termination of pregnancy or hysterosalpingography. Targeted antibiotics on identified bacteria are better than systematic antibioprophylaxis in those conditions. CONCLUSIONS Current management of PID requires easily reproducible investigations and antibiotics adapted to STI and vaginal microbiota.
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Affiliation(s)
- J-L Brun
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux, France.
| | - B Castan
- Unité fonctionnelle d'infectiologie régionale, centre hospitalier d'Ajaccio, 27, avenue Impératrice-Eugénie, 20303 Ajaccio, France
| | - B de Barbeyrac
- Centre national de référence des infections sexuellement transmissibles bactériennes, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - C Cazanave
- Centre national de référence des infections sexuellement transmissibles bactériennes, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - A Charvériat
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - K Faure
- Service des maladies infectieuses, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France
| | - S Mignot
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - R Verdon
- Service de maladies infectieuses et tropicales, CHRU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - X Fritel
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - O Graesslin
- Service de gynécologie-obstétrique, institut Mère-Enfant Alix-de-Champagne, 45, rue Cognacq-Jay, 51092 Reims, France
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19
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Ah-Kit X, Hoarau L, Graesslin O, Brun JL. [Follow-up and counselling after pelvic inflammatory disease: CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines]. ACTA ACUST UNITED AC 2019; 47:458-464. [PMID: 30878686 DOI: 10.1016/j.gofs.2019.03.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To determine the procedures for follow-up and counselling of patients after pelvic inflammatory disease (PID). METHODS A search in the Cochrane database, PubMed, and Google was performed using keywords related to follow-up and PID to identify reports published between 1990 and 2018. All studies published in French and English relevant to the areas of focus were included. A level of evidence (LE) based on the quality of the data available was applied for each area of focus and used for the guidelines. RESULTS The rate of recurrent PID is 15 to 21%. They are related to a recurrent sexually transmitted infection (STI) in 20 to 34% of cases. Recurrence PID increase the risk of infertility and chronic pelvic pain (LE2). Follow-up is recommended after PID (grade C). The rate of patients lost to follow-up is around 40%. Follow-up is improved by personalized text message reminders (grade B). Vaginal sampling for detection of N. gonorrhoeae, C. trachomatis, (and M. genitalium) by nucleic acid amplification techniques is recommended 3 to 6 months after treatment of PID associated with STI to rule out possible reinfections (grade C). The use of condoms after PID associated with STI is recommended to reduce the risk of recurrences (grade C). The systematic use of contraceptive pills after PID is not recommended to prevent subsequent infertility and chronic pelvic pain. Vaginal sampling for microbiological diagnosis is recommended before the insertion of an intrauterine device (grade B). The risk of ectopic pregnancy is high in these women and must be kept in mind. CONCLUSION Patient counselling and microbiological testing after PID decrease the risk of STI and thus the recurrence of PID.
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Affiliation(s)
- X Ah-Kit
- Pôle d'obstétrique - reproduction - gynécologie, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - L Hoarau
- Pôle d'obstétrique - reproduction - gynécologie, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - O Graesslin
- Service de gynécologie-obstétrique, institut Mère-Enfant Alix-de-Champagne, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - J-L Brun
- Pôle d'obstétrique - reproduction - gynécologie, centre Aliénor d'Aquitaine, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; UMR 5234, microbiologie fondamentale & pathogénicité, université de Bordeaux, 33076 Bordeaux, France.
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Lanot A, Bouvier N, Chatelet V, Lecouf A, Tillou X, Hurault de Ligny B. [Outcome of living kidney donors for transplantation]. Nephrol Ther 2017; 13:448-459. [PMID: 29031488 DOI: 10.1016/j.nephro.2017.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/27/2016] [Revised: 01/24/2017] [Accepted: 02/01/2017] [Indexed: 01/10/2023]
Abstract
Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality. The first results did not show any risk linked to kidney donation, compared to general population. However, since 2013, kidney donors were found at higher risk for kidney failure and even for mortality, compared with controls selected like donor candidates. The risk of kidney donation is nevertheless acceptable and minimal, on the condition of rigorous selection of candidates and regular follow-up.
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Affiliation(s)
- Antoine Lanot
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France.
| | - Nicolas Bouvier
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France
| | - Valérie Chatelet
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Angélique Lecouf
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Xavier Tillou
- Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France; Service d'urologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Bruno Hurault de Ligny
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France
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Van Beeck A, Van den Broek M, Michielsen M, Didden K, Vuylsteke K, Verstreken F. Efficacy and safety of collagenase treatment for Dupuytren's disease: 2-year follow-up results. Hand Surg Rehabil 2017; 36:346-349. [PMID: 28732844 DOI: 10.1016/j.hansur.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/01/2017] [Accepted: 06/13/2017] [Indexed: 01/24/2023]
Abstract
Dupuytren's contracture is a common hand problem that affects the palmar fascia. Several treatment options exist, but none are curative and recurrence is common. Bacterial collagenase has recently been proven beneficial for treating Dupuytren's disease, cleaving the collagen fibers at different sites, with weakening and eventually rupture of the fibrous cords after manipulation. An independent prospective follow-up study was organized on 87 patients, treated with one or more collagenase injections. Inclusion criteria were a contracture of at least 20° at the metacarpophalangeal (MCP) or the proximal interphalangeal (PIP) joint. The most diseased joint was taken into consideration for follow-up evaluation. The resulting extension deficit was measured at 1 month, 1 year and 2 years and was graded as "clinical success", "clinical improvement" or "clinical failure". The mean contracture improved from 45° (39° for MCP and 54° for PIP joints) before treatment to 5° (2° for MCP and 9° for PIP joints) 4 weeks after treatment. No serious complications occurred. After 2 years, 68 joints were evaluated; 61.5% of the MCP joints and 34.5% of the PIP joints had a contracture of ≤20°. When compared with the 4-week evaluation, 28.2% of MCP joints and 62.1% of PIP joints had a recurrence (20° or greater worsening) or had received additional treatment. Collagenase injection is a safe and effective treatment option for Dupuytren disease, but recurrence is common especially for the PIP joint.
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Affiliation(s)
- A Van Beeck
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium.
| | - M Van den Broek
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium
| | - M Michielsen
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium
| | - K Didden
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium
| | - K Vuylsteke
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium
| | - F Verstreken
- Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium
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Rochette C, Castinetti F, Brue T. [Acromegaly and Cushing's disease: Persistence of comorbidities after the control of hypersecretion]. Ann Endocrinol (Paris) 2017. [PMID: 28645354 DOI: 10.1016/s0003-4266(17)30074-4] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Acromegaly and Cushing's disease lead to common and distinct comorbidities. Currently available treatments lead to the control of hyper secretion in the majority of cases. However, the prevalence of the comorbidities does not always go back to the one of the normal population after remission. For instance, about 1/3 of acromegalic patients with diabetes and half of patients with Cushing's disease and diabetes will have normal blood glucose values after remission. In contrast, high blood pressure frequently recovers after remission in both diseases. In contrast, while patients with acromegaly improve their lipid profile, patients with Cushing's disease frequently remain hypertriglyceridemic. Many other comorbidities (cardiovascular disease, bone alterations, altered quality of life) may persist after the control of hyper secretion. The aim of this review is to focus on the outcome of patients with acromegaly and Cuhing's disease, and to suggest the optimal follow-up of such patients in a multidisciplinary approach. These points have been discussed during the 2016 European Congress of Endocrinology, notably by J.Romijn and E.Valassi.
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Affiliation(s)
- C Rochette
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France
| | - F Castinetti
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France; Faculté de Médecine Secteur Nord, CNRS UMR 7286 - CRN2M, Boulevard Pierre Dramard, 13015 Marseille, France
| | - T Brue
- Université d'Aix-Marseille, Jardin du Pharo, 58 Boulevard Charles Livon, 13284 Marseille, France; Service d'endocrinologie-diabète-maladies métaboliques, Pôle ENDO, Centre de Référence Pathologies hypophysaires Rares, Hôpital de la Conception, 147 Boulevard Baille, 13005 Marseille, France; Faculté de Médecine Secteur Nord, CNRS UMR 7286 - CRN2M, Boulevard Pierre Dramard, 13015 Marseille, France.
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Saint F, Prader R, Cordonnier C, Choukroun G, Elesper N, Desailloud R. [Long-term blood pressure outcome after unilateral adrenalectomy for primary hyperaldosteronism]. Prog Urol 2017; 27:389-394. [PMID: 28259701 DOI: 10.1016/j.purol.2017.01.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/26/2016] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify prognostic factors associated. METHODS Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic BP under treatment, identification of anti-hypertension treatment), biological evaluation (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI). Blood pressure was assessed postoperatively at 1 month, 1 year, then at the date of the latest news. The patients were classified into three categories: cured (no antihypertensive therapy in postoperative associated with strictly lower blood pressures of 140/90mmHg), improved (decreased number of drugs or number unchanged but with better blood pressure control), and refractory (no change in the number of drug and blood pressure, or deterioration of one or other of these two parameters). RESULTS We evaluated 43 patients, 23 men and 20 women, with a median follow-up of 74.4 months [16.8 to 141]. Pathological analysis described 34 adenomas (79%), 7 hyperplasias (16%) (5 micro-nodular and 2 macro-nodular) and 2 adrenocortical carcinoma (5%). The postoperative long-term assessment found 20% of cured patients (n=8), 65% of improved (n=26) and 15% of refractory (n=6). Prognostic factors associated with favorable long-term blood pressure outcome were those typically associated with ARS score [preoperative number of anti-hypertension drugs (P=0.005), BMI<25kg/m2 (P=0.009), and duration of hypertension (P=0.007)]. CONCLUSION Adrenalectomy for PA is a long-term effective treatment for blood pressure control. Prognostic factors associated with long-term success are those conventionally described in ARS score. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- F Saint
- Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Laboratoire de recherche HeRVI EA3801, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Centre de ressources biologiques, biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
| | - R Prader
- Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - C Cordonnier
- Service d'anatomie et cytologie pathologiques, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - G Choukroun
- Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - N Elesper
- Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
| | - R Desailloud
- Service d'endocrinologie, maladies métaboliques, diabétologie et nutrition, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France
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Rehailia-Blanchard A, Pigné G, Guy JB, Vallard A, El Meddeb Hamrouni A, Rancoule C, Magné N. [Care of Merkel cell carcinoma and role of the radiotherapy]. Bull Cancer 2016; 104:101-108. [PMID: 27989628 DOI: 10.1016/j.bulcan.2016.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 11/30/2022]
Abstract
Merkel cell carcinoma is a rare neuro-endocrine tumor of skin with a poor prognosis. Data available in literature are scarce. Current treatment for locoregional disease is based on combined treatment by surgery and radiotherapy. However these treatments are controversial. The aim of the present review is to sum up the different available studies and to compare national and international guidelines.
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Affiliation(s)
- Amel Rehailia-Blanchard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France
| | - Grégoire Pigné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France
| | - Jean-Baptiste Guy
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France
| | - Alexis Vallard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France
| | - Anis El Meddeb Hamrouni
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France
| | - Chloé Rancoule
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest en Jarez, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du Grand-Revoyet, BP 12, 69921 Oullins cedex, France.
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Garcia D, Mahieu L, Soubrane G, Salmon L, Renouvin A, Pagot-Mathis V, Matonti F, Soler V. Follow-up after surgery for hemorrhagic AMD. J Fr Ophtalmol 2016; 39:661-7. [PMID: 27658564 DOI: 10.1016/j.jfo.2016.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/12/2016] [Accepted: 05/27/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The long-term functional results of macular hematoma (MH) surgery in exudative AMD are often limited. The goal of this study was to compare visual outcomes of monthly versus bimestrial follow-up in these patients. METHODS Retrospective, interventional case series. Population : 21 eyes of 21 patients with SMH associated with exudative AMD. INCLUSION CRITERIA first SMH associated with exudative AMD, with 1-year postoperative follow-up. EXCLUSION CRITERIA blood located exclusively underneath the retinal pigment epithelium on OCT imaging, SMH due to different etiology, lost to follow-up, ≤5 postoperative visits and a different surgical protocol as described. Patients were divided into two groups according to the number of postoperative visits (number of intravitreal injections [IVT] combined with the number of consultations, only one visit was recorded when IVT and consultation occurred on the same day) during the 1-year postoperative follow-up: group 1 had ≥11 visits (n=8); group 2 had 6 to 10 visits (n=13). All eyes underwent vitrectomy with subretinal injection of recombinant tissue plasminogen activator, fluid-gas exchange and anti-VEGF intravitreal injection. The main outcome was change in best-corrected visual acuity (BCVA). RESULTS Considering visual acuity (VA) change between 1-month and 1-year postoperative follow-up examinations, group 1 had statistically significant greater VA changes (logMAR -0.29±0.44 vs logMAR 0.42±0.73; P=0.016; P=0.016). In patients that had exudative recurrences (ER), group 1 received more anti-VEGF IVT than group 2 (P=0.045). CONCLUSION Our results showed that monthly follow-up, between the IVT series, is highly recommended to preserve postoperative VA in patients undergoing surgery for SMH associated with AMD.
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Ganry L, Blot P, Balandier S, Bouric JM, Sabouni W, Corre P, Khonsari RH. [Quantitative study of phonation by aerophonoscopy: Reproducibility study on healthy volunteers]. ACTA ACUST UNITED AC 2016; 117:62-6. [PMID: 26704194 DOI: 10.1016/j.revsto.2015.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 09/29/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The aerophonoscope allows for recording buccal and nasal airflow during breathing and speech and the sounds emitted by the patient. It is known to be useful in the postoperative follow-up of cleft lip and palate children, but there are currently no studies that quantitatively validate its reliability in pathological or non-pathological situations. The aim of our study was to measure the reliability of aerophonoscopic measures in adult healthy volunteers. MATERIAL AND METHODS A quantitative evaluation of the reliability of aerophonoscopy has been carried out in 30 healthy adult volunteers by measuring its inter- and intra-individual reproducibility and its sensibility in relation with the degree of the velopharyngeal sphincter constriction using a test-retest protocol. RESULTS The aerophonoscope allows for inter- and intra-individual reproducible measures in healthy adult volunteers. Its sensibility to velopharyngeal sphincter constriction is good in healthy adult volunteers. DISCUSSION The interest of aerophonoscopy in the treatment strategy of cleft lip and palate patients remains unclear. More reliable quantitative data would be of major interest to determine whether this device is suitable for the follow-up of cleft lips and palate patients or not. This would also allow for planning a second soft-palate operation and for assessing the efficacy of revision surgery such as superior or inferior pedicled pharyngoplasty.
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Amelot F, Picot E, Meusy A, Rousseau C, Brun M, Guillot B. [Syphilis in Montpellier, France, from 2002 to 2011: Survey in a free hospital screening centre for venereal disease and in the dermatology unit of a regional public hospital]. Ann Dermatol Venereol 2015; 142:742-50. [PMID: 26362133 DOI: 10.1016/j.annder.2015.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 09/19/2014] [Revised: 04/15/2015] [Accepted: 07/09/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND In a context of resurgent syphilis in France since 2000, we conducted a retrospective study in two different centres in Montpellier, France: the dermatology department of a public hospital and an anonymous and free centre for provision of information, diagnosis and treatment of venereal diseases (CDAG-CIDDIST). PATIENTS AND METHODS All patients with syphilis seen from January 2002 to December 2011 were included with the collaboration of the National Health Institute (InVS) and the Bacteriology Department of the public hospital. Epidemiology, clinical presentation, serological data, and treatment and monitoring data for up to 2 years were recorded. RESULTS One hundred and seventy-five cases of syphilis were diagnosed: 154 at the CDAG and 21 at the dermatology unit. Ninety-six percent of cases concerned men with a median age of 36 years. Eighty-two percent of these cases involved men having sex with men (MSM). Forty-nine percent of cases were diagnosed in the secondary stage, 22% in the primary stage and 28% in the latent stage. The treatment administered in the majority of cases (73%) was benzathine-penicillin G. The numbers of patients showing incomplete follow-up were equal at both centres, with 31 patients (17.7%) failing to attend the follow-up visit. A decrease of at least 2 dilutions in VDRL score occurred in the year following treatment for 93 of 103 patients (90%). Patients managed at the dermatology department were older than their counterparts managed at the CDAG and exhibited more frequent cutaneous eruptions (58% vs. 3%, P<0.0001) but were less frequently bisexual. However, no significant differences were seen concerning sex and associated infections (hepatitis, gonococcal infection, HPV or herpes). DISCUSSION Syphilis is on the rise, especially in the MSM population. The epidemiological characteristics of our cohort were consistent with those of other Western European countries. Although the reasons for consultation differed between CDAG/CIDDIST and the dermatology department, the two centres are complementary. Benzathine-penicillin G was the most commonly used treatment, in accordance with the recommendations. Measures must be introduced to improve patient monitoring without compromising anonymity.
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Affiliation(s)
- F Amelot
- Département de dermatologie, CHU, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34000 Montpellier, France.
| | - E Picot
- CDAG/CIDDIST de Montpellier, département de dermatologie, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - A Meusy
- Département de l'information médicale, hôpital La-Colombière, 39, avenue Charles-Flahault, 34295 Montpellier cedex 5, France
| | - C Rousseau
- Cellule de l'InVS en région languedoc-roussillon (CIRE), département coordination des alertes et des régions, institut de veille sanitaire, ARS LR - 28 Parc-Club du Millénaire, 1025, rue Henri-Becquerel, CS3000, 34067 Montpellier cedex 2, France
| | - M Brun
- Laboratoire de bactériologie, hôpital Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
| | - B Guillot
- Département de dermatologie, CHU, hôpital Saint-Éloi, 80, avenue Augustin-Fliche, 34000 Montpellier, France
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Clément-Colmou K, Troussier I, Bardet É, Lapeyre M. [Clinical and paraclinical follow-up after radiotherapy for head and neck cancer]. Cancer Radiother 2015; 19:597-602. [PMID: 26278985 DOI: 10.1016/j.canrad.2015.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 05/20/2015] [Indexed: 11/26/2022]
Abstract
Head and neck cancer management often involves heavy multimodal treatments including radiotherapy. Despite the improvement of intensity-modulated radiation therapy, acute and late toxicities remain important. After such treatment, patients have to face different potential problems, depending on the post-therapeutic delay. In this way, short-term follow-up permits to appreciate the healing of acute toxicities and response to treatment. Long-term follow-up aims to recognize second primitive tumours and distant failure, and to detect and manage late toxicities. Medical and psychosocial supportive cares are essential, even after several years of complete remission. The objective of this article is to review the modalities of short-term and long-term follow-up of patients who receive a radiotherapy for head and neck cancer.
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Affiliation(s)
- K Clément-Colmou
- Département de radiothérapie, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.
| | - I Troussier
- Département d'oncologie-radiothérapie, CHRU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - É Bardet
- Département de radiothérapie, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
| | - M Lapeyre
- Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France
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Behar T, Menjot N, Laroche JP, Böge B, Quéré I, Galanaud JP. Comparative evolution of carotidynia on ultrasound and magnetic resonance imaging. ACTA ACUST UNITED AC 2015; 40:395-8. [PMID: 26163344 DOI: 10.1016/j.jmv.2015.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 11/19/2014] [Accepted: 05/29/2015] [Indexed: 11/25/2022]
Abstract
Carotidynia is rare and associates neck pain with tenderness to palpation usually over the carotid bifurcation, the diagnosis of which is based on magnetic resonance imaging (MRI). Ultrasounds (US) are also frequently used but their accuracy in predicting the course of the disease is unknown. We are reporting the case of a 52-year-old man who presented a typical carotidynia. Clinical symptoms, ultrasound and MRI imaging evolution were closely correlated. Our case suggest that after a first MRI to set a positive diagnosis of carotidynia and exclude differential diagnoses, US which is more widely available and less expensive could constitute the imaging of reference for the follow-up.
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Affiliation(s)
- T Behar
- Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France.
| | - N Menjot
- Department of neuroradiology, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - J-P Laroche
- Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - B Böge
- Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - I Quéré
- Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
| | - J-P Galanaud
- Clinical investigation center and department of internal medicine, hôpital de Montpellier, university hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France
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Affiliation(s)
- J-M Oppert
- Service de nutrition, GH Pitié-Salpêtrière (AP-HP), institut cardiométabolisme et nutrition (ICAN), université Pierre-et-Marie-Curie, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
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31
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Zendjabil M. [The glycated hemoglobin: indication, interpretation and limitations]. Ann Pharm Fr 2015; 73:336-9. [PMID: 25857744 DOI: 10.1016/j.pharma.2015.03.001] [Citation(s) in RCA: 3] [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: 08/20/2014] [Revised: 02/19/2015] [Accepted: 03/07/2015] [Indexed: 10/23/2022]
Abstract
HbA1c is defined by the slow and irreversible binding of glucose to the N-terminal valine of one or both of the beta chains of hemoglobin A (HbA). It is a marker that is becoming increasingly important because of its role in both the diagnosis and monitoring of diabetic patients with type 1 and type 2. It reflects glycemic control of two or three months. Learned societies such as the IFCC and NGSP contributed to its standardization, which allows inter-laboratory comparison of results. Its assay uses chromatographic, electrophoretic or immunochemical methods. The HbA1c concentration is expressed in percent and in mmol/mol, and a number that is between 4 and 6% (20 and 42mmol/mol) is desirable. However, HbA1c cannot be used in some cases and fructosamine assay must be considered.
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Affiliation(s)
- M Zendjabil
- Laboratoire de biochimie, établissement hospitalier universitaire d'Oran 1(er)-Novembre-1954, BP 4166 Ibn Rochd, Oran, Algérie.
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Morichau-Beauchant T, Boulé S, Guédon-Moreau L, Finat L, Botcherby EJ, Périer MC, Salleron J, Guibout C, Marquié C, Klug D, Kouakam C, Wissocque L, Brigadeau F, Lacroix D, Kacet S. Remote monitoring of patients with implantable cardioverter-defibrillators: can results from large clinical trials be transposed to clinical practice? Arch Cardiovasc Dis 2014; 107:664-71. [PMID: 25241223 DOI: 10.1016/j.acvd.2014.07.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/28/2014] [Accepted: 07/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Remote monitoring (RM) is increasingly used to follow up patients with implantable cardioverter-defibrillators (ICDs). Randomized control trials provide evidence for the benefit of this intervention, but data for RM in daily clinical practice with multiple-brands and unselected patients is lacking. AIMS To assess the effect of RM on patient management and clinical outcome for recipients of ICDs in daily practice. METHODS We reviewed ICD recipients followed up at our institution in 2009 with RM or with traditional hospital only (HO) follow-up. We looked at the effect of RM on the number of scheduled ambulatory follow-ups and urgent unscheduled consultations, the time between onset of asymptomatic events to clinical intervention and the clinical effectiveness of all consultations. We also evaluated the proportion of RM notifications representing clinically relevant situations. RESULTS We included 355 patients retrospectively (RM: n=144, HO: n=211, 76.9% male, 60.3±15.2 years old, 50.1% with ICDs for primary prevention and mean left ventricular ejection fraction 35.5±14.5%). Average follow-up was 13.5 months. The RM group required less scheduled ambulatory follow-up consultations (1.8 vs. 2.1/patient/year; P<0.0001) and a far lower median time between the onset of asymptomatic events and clinical intervention (7 vs. 76 days; P=0.016). Of the 784 scheduled ambulatory follow-up consultations carried out, only 152 (19.4%) resulted in therapeutic intervention or ICD reprogramming. We also found that the vast majority of RM notifications (61.9%) were of no clinical relevance. CONCLUSION RM allows early management of asymptomatic events and a reduction in scheduled ambulatory follow-up consultations in daily clinical practice, without compromising safety, endorsing RM as the new standard of care for ICD recipients.
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Affiliation(s)
| | - Stéphane Boulé
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France.
| | | | - Loïc Finat
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France
| | - Edward J Botcherby
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France
| | - Marie-Cécile Périer
- Inserm U970, Paris Cardiovascular Research Centre, Paris Descartes University, Sorbonne Paris Cité, 75015 Paris, France
| | - Julia Salleron
- Lille University Hospital, Biostatistics Unit, 59037 Lille, France
| | - Catherine Guibout
- Inserm U970, Paris Cardiovascular Research Centre, Paris Descartes University, Sorbonne Paris Cité, 75015 Paris, France
| | - Christelle Marquié
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France
| | - Didier Klug
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France; University of Lille 2, Faculty of Medicine, 59045 Lille, France
| | - Claude Kouakam
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France
| | - Ludivine Wissocque
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France; University of Lille 2, Faculty of Medicine, 59045 Lille, France
| | - François Brigadeau
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France
| | - Dominique Lacroix
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France; University of Lille 2, Faculty of Medicine, 59045 Lille, France
| | - Salem Kacet
- Lille University Hospital, Department of Cardiovascular Medicine, 59037 Lille, France; University of Lille 2, Faculty of Medicine, 59045 Lille, France
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Federspiel C, Brembilla-Perrot B. Prevalence, causes of reappearance of symptoms or preexcitation syndrome after ablation of accessory pathway and management. Ann Cardiol Angeiol (Paris) 2014; 63:89-94. [PMID: 24613003 DOI: 10.1016/j.ancard.2014.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
AIM The purpose of the study was to look for the prevalence, significance and management of preexcitation syndrome (PS) or symptoms reappearance after accessory pathway (AP) ablation. AP ablation actually is the first treatment of PS. METHODS Successful AP ablation was performed in 261 patients; reappearance of symptoms or PS on ECG occurred in 47 patients (18%) from 20minutes to several years. Their data were compared with remaining patients. RESULTS Recurrences were more frequent in patients with spontaneous malignant form (34 vs. 21%), in congenital heart disease (4.2 vs. 0%) (P<0.002), in case of complication (11 vs. 2%) (P<0.007) and of a longer duration of applications (304±209 vs. 188±182sec) (P<0.019). Forty percent of patients had the same symptoms and electrophysiological data as before ablation. Twenty-four percent had an improvement of symptoms and/or electrophysiological data. However, 3 initially asymptomatic patients became symptomatic after ablation. Twenty-six percent had another AP or another rhythm disorder. We recommend transesophageal electrophysiological study for the control because only 40% of patients required second ablation. CONCLUSIONS Reappearance of symptoms or a PS on ECG after AP ablation was not rare (18%) and was inconsistently associated with the reappearance of all initial AP electrophysiological properties. Only 40% of patients required a second AP ablation. Another arrhythmia was possible. Non-invasive second evaluation should be preferred. However, asymptomatic patients before ablation could become symptomatic.
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Affiliation(s)
- C Federspiel
- Cardiology, CHU of Brabois, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - B Brembilla-Perrot
- Cardiology, CHU of Brabois, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
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Sankaredja J, Brac B, Thines L, Baroncini M, Zairi F, Cardot-Bauters C, Lejeune JP. [Epidemiology, treatment and follow-up of central nervous system hemangioblastomas in von Hippel-Lindau disease]. Rev Neurol (Paris) 2014; 170:288-96. [PMID: 24680832 DOI: 10.1016/j.neurol.2013.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/29/2011] [Revised: 12/07/2013] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Central nervous system (CNS) hemangioblastomas (HGB) are rare vascular tumors. The goal of this study was to analyze their epidemiology, treatment and prognosis in association with von Hippel-Lindau (VHL) disease. METHODS We retrospectively reviewed a series of patients treated in our department for a CNS HGB with VHL disease between 1996 and 2008. We analyzed pre- and postoperative clinical and radiological characteristics, number of visceral lesions (fundoscopy, abdomino-pelvian CT, metanephrines), clinical course (modified Rankin Scale and McCormick scale) and late prognosis (Kaplan-Meier survival curves). RESULTS We studied 19 cases (sex-ratio 0.9, mean age 36). The mean time to diagnosis was 61days. The main symptom was intracranial hypertension for cerebellar lesions (7/15) and a sensitive-motor deficit for medulla oblongata (2/5) or spinal lesions (5/11). Preferred locations were cerebellum (15/31), often nodulo-cystic appearance, followed by spinal cord (11/31), frequently coming with adjacent syringomyelia. Multiple locations and visceral lesions were found in two-third of the cases. Surgical removal was complete in more than three-quarter of the cases. Mean follow-up duration was 9years. Postoperative mortality rate was 16%. In cerebellar and medulla oblongata locations together, final mRS was ≤1 in 17 of the 20 cases. In spinal cord locations, final McCormick score was ≤2 in all the cases. After delayed follow-up, about two-third of patients experienced recurrence or new progressive CNS lesions. CONCLUSION HGB are rare CNS tumors. VHL disease should be considered when an HGB is diagnosed before 30, is located at the spinal cord, comes with multiple other CNS lesions or with typical peripheral lesions. Microsurgical removal is the gold standard treatment and can offer good functional results.
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Affiliation(s)
- J Sankaredja
- Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - B Brac
- Faculté de médecine de Lille, université Lille 2 (Option Initiation à la Rédaction d'Article), 1, place de Verdun, 59000 Lille, France
| | - L Thines
- Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France; Faculté de médecine de Lille, université Lille 2 (Option Initiation à la Rédaction d'Article), 1, place de Verdun, 59000 Lille, France.
| | - M Baroncini
- Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - F Zairi
- Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
| | - C Cardot-Bauters
- Service de médecine interne et d'endocrinologie, hôpital Huriez, CHRU de Lille, université Lille Nord-de-France, 1, place de Verdun, 59000 Lille, France
| | - J-P Lejeune
- Clinique de neurochirurgie, pôle des neurosciences et de l'appareil locomoteur, hôpital Roger-Salengro, CHRU de Lille, université Lille Nord-de-France, avenue du Pr-Émile-Laine, 59037 Lille cedex, France
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