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Descalzo JM, Frutos EL, Castro J, Lombardo VR, Gimenez C, Otero P, Luna D, Otero C. Improving Waiting Time for Chemotherapy with Ahead-of-Time Drug Preparation. Stud Health Technol Inform 2024; 310:144-148. [PMID: 38269782 DOI: 10.3233/shti230944] [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] [Indexed: 01/26/2024]
Abstract
Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.
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Affiliation(s)
- Juan Marcos Descalzo
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | | | - Javier Castro
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | | | - Cintia Gimenez
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Paula Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), UE de triple dependencia CONICET - Instituto Universitario del Hospital Italiano (IUHI) - Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
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Brouillet D, Servajean P, Josa R, Gimenez C, Turo S, Michalland AH. The subjective feeling of a gap between conceptual and perceptual fluency is interpreted as a metacognitive signal of pastness. Cogn Process 2023; 24:83-94. [PMID: 36527528 PMCID: PMC9759051 DOI: 10.1007/s10339-022-01114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022]
Abstract
The present study aimed to address the following question: does the discrepancy between an expected word and its readability enhances or impair its memorability? We used an adaptation of the sentence stem paradigm (Whittlesea in J Exp Psycol 19:1235-1253, 1993) and manipulated the perceptual clarity of the words by introducing some Gaussian noise (Reber in Psycol Sci 9:45-48, 1998). The target words were semantically predictable or otherwise (conceptual fluency) or were easy or difficult to read (perceptual fluency). The first experiment was conducted to ensure that the two manipulated factors had an impact on the readability of the words. In particular, results showed that when the words were written against a noisy background their predictability enhanced the judgement of readability. The second experiment aimed to test the hypothesis that recognition would be influenced by the discrepancy between conceptual and perceptual fluency. The results showed that with a noisy background, the predictability of the target words had an impact on recognition judgement; with a clear background, the effect on the recognition judgement was caused by the non-predictability of the target words. Conversely, confidence in judgement increased when the two factors went in the same direction, that is, predictability with clarity and non-predictability with low clarity. The results showed that (a) depending on the task, the effects of conceptual and perceptual fluency did not go in the same direction; (b) the kinds of fluency (conceptual and perceptual) were not independent; and (c) recognition judgements were affected by the gap between conceptual and perceptual fluency.
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Affiliation(s)
- D. Brouillet
- EPSYLON, Laboratoire de Psychologie (EA 4556), Université Paul Valéry Montpellier 3, Route de Mende, Montpellier, France
| | - P. Servajean
- EPSYLON, Laboratoire de Psychologie (EA 4556), Université Paul Valéry Montpellier 3, Route de Mende, Montpellier, France ,LPNC, Université Grenoble Alpes, Grenoble, France
| | - R. Josa
- LAPSCO, Laboratoire de Psychologie Sociale Et Cognitive, Université Clermont Auvergne, Clermont-Ferrand, France
| | - C. Gimenez
- EPSYLON, Laboratoire de Psychologie (EA 4556), Université Paul Valéry Montpellier 3, Route de Mende, Montpellier, France
| | - S. Turo
- EPSYLON, Laboratoire de Psychologie (EA 4556), Université Paul Valéry Montpellier 3, Route de Mende, Montpellier, France ,LIFAM, Laboratoire Innovation Forme Architecture Milieux—Université Montpellier, Montpellier, France
| | - A. H. Michalland
- EPSYLON, Laboratoire de Psychologie (EA 4556), Université Paul Valéry Montpellier 3, Route de Mende, Montpellier, France ,i2ml Fondation, Institut Méditerranéen Des Métiers de La Longévité, Nîmes, France ,LIFAM, Laboratoire Innovation Forme Architecture Milieux—Université Montpellier, Montpellier, France
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Frutos EL, Muñoz AM, Rovegno L, Pedretti AS, Otero CM, Gimenez C, Luna DR, Grande Ratti MF, Martinez BJ. Can CPOE Based on Electronic Order Sets Cause Unintended Consequences (Expensive and Unnecessary Tests) at the Emergency Department? Stud Health Technol Inform 2022; 290:192-196. [PMID: 35672998 DOI: 10.3233/shti220059] [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] [Indexed: 06/15/2023]
Abstract
Computerized Provider Order Entry (CPOE) systems may cause unintended consequences. This study aimed to describe the on-going system for CPOE order sets, and to explore an economic evaluation at the Emergency Department. First, we developed a costs dashboard which showed us the significant and excessive use of medical tests per consultation. We identified the top 10 most widely used and most expensive tests. Additionally we noticed that the labs seemed to continually increase. Then, we found that 27% of the consultations have at least one item of laboratory practice between January and February 2020, and this represents more than 80% of the consultation costs. Health care spending has reached epic proportions globally. We think that it is time to rethink effective strategies. Maybe it is time to deactivate/remove electronic order sets (EOSs) and the functionality to develop and create their own "private" order sets, in order to eliminate waste and inefficiencies.
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Affiliation(s)
- Eliana Ludmila Frutos
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Agustín Matías Muñoz
- Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Luciana Rovegno
- Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ana Soledad Pedretti
- Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Martin Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Cintia Gimenez
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Daniel Roberto Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - María Florencia Grande Ratti
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
- Emergency Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Gimenez C, de Matos Lima S, Luna D. Evaluating the Use of a CPOE for Chemotherapy Protocols. Stud Health Technol Inform 2020; 270:1271-1272. [PMID: 32570614 DOI: 10.3233/shti200397] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chemotherapy drugs are one of the most common causes of serious and fatal medication errors, especially during prescribing, where computerized physician order entry (CPOE) take on importance. This study proposes the description of the post-implementation status of a CPOE in a highly specialized hospital between January and June 2018, among patients older than 18 years. Results: a total of 8835 protocols were indicated using the specific CPOE (93% use rate over all protocols) 91% completed the administration, 1.2% were rejected by pharmacy, and 6.8% was canceled. The most frequent cause of rejection by pharmacy and cancellation by oncologist was an inadequate dose. Most of the protocols indicated using the CPOE implemented, with a reject by pharmacy rate of 1.2%, indicates the utility of CPOE as an error prevention strategy.
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Affiliation(s)
- C Gimenez
- Department of Biomedical Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - S de Matos Lima
- Department of Biomedical Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - D Luna
- Department of Biomedical Informatics, Hospital Italiano de Buenos Aires, Argentina
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Gimenez C, Zafra F, Aragon C. [Pathophysiology of the glutamate and the glycine transporters: new therapeutic targets]. Rev Neurol 2018; 67:491-504. [PMID: 30536363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The amino acids glutamate and glycine, apart from their role in protein synthesis, are two fundamental neurotransmitters in the central nervous system of mammals. The first one is ubiquitous and is involved in excitatory pathways of the neocortex, the retina and the cerebellum, and the second is involved in inhibitory pathways of brain caudal areas. However, both share their way of acting by integrating into the functioning of glutamate receptors of the NMDA type fundamentals in the regulation of motor, sensory and cognitive systems. AIM To highlight the need for a fine regulation of glutamate and glycine concentrations in the intracellular and extracellular spaces of the nervous system through the action of very specific transporters for both neurotransmitters located in the plasma membrane of neurons and glial cells. DEVELOPMENT The role of the glutamate and glycine transporters in glutamatergic and glycinergic neurotransmission and in the functioning of the nervous system is described. The pathological consequences of imbalances in these signaling pathways are pointed out. We also describe its involvement in pathologies such as schizophrenia, chronic pain, cerebral ischemia, diseases such as hereditary hyperekplexia and the non-ketotic hyperglycinemia, and neurodegenerative disorders. CONCLUSIONS The knowledge at molecular level of the way of acting of these transporters for glutamate and glycine is allowing the identification and development of new therapeutic strategies for pathologies such as those described above and the development of new drugs.
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Affiliation(s)
- C Gimenez
- Centro de Biologia Molecular Severo Ochoa. Universidad Autonoma de Madrid, Madrid, Espana
| | - F Zafra
- Centro de Biologia Molecular Severo Ochoa. Universidad Autonoma de Madrid, Madrid, Espana
| | - C Aragon
- Centro de Biologia Molecular Severo Ochoa. Universidad Autonoma de Madrid, Madrid, Espana
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Navoni JA, De Pietri D, Olmos V, Gimenez C, Bovi Mitre G, de Titto E, Villaamil Lepori EC. Human health risk assessment with spatial analysis: study of a population chronically exposed to arsenic through drinking water from Argentina. Sci Total Environ 2014; 499:166-74. [PMID: 25181048 DOI: 10.1016/j.scitotenv.2014.08.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/18/2014] [Accepted: 08/18/2014] [Indexed: 05/12/2023]
Abstract
Arsenic (As) is a ubiquitous element widely distributed in the environment. This metalloid has proven carcinogenic action in man. The aim of this work was to assess the health risk related to As exposure through drinking water in an Argentinean population, applying spatial analytical techniques in addition to conventional approaches. The study involved 650 inhabitants from Chaco and Santiago del Estero provinces. Arsenic in drinking water (Asw) and urine (UAs) was measured by hydride generation atomic absorption spectrophotometry. Average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR) were estimated, geo-referenced and integrated with demographical data by a health composite index (HI) applying geographic information system (GIS) analysis. Asw covered a wide range of concentration: from non-detectable (ND) to 2000 μg/L. More than 90% of the population was exposed to As, with UAs levels above the intervention level of 100 μg/g creatinine. GIS analysis described an expected level of exposure lower than the observed, indicating possible additional source/s of exposure to inorganic arsenic. In 68% of the locations, the population had a HQ greater than 1, and the CR ranged between 5·10(-5) and 2,1·10(-2). An environmental exposure area through ADD geo-referencing defined a baseline scenario for space-time risk assessment. The time of residence, the demographic density and the potential health considered outcomes helped characterize the health risk in the region. The geospatial analysis contributed to delimitate and analyze the change tendencies of risk in the region, broadening the scopes of the results for a decision-making process.
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Affiliation(s)
- J A Navoni
- Cátedra de Toxicología y Química Legal, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina.
| | - D De Pietri
- Dirección Nacional de Determinantes de la Salud e Investigación, Ministerio de Salud de la Nación, Av. 9 de Julio 1925, C1073ABA Ciudad Autónoma de Buenos Aires, Argentina.
| | - V Olmos
- Cátedra de Toxicología y Química Legal, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - C Gimenez
- Cátedra Química Analítica I, Universidad Nacional del Chaco Austral. Cmte., Fernández 755 (3700), Pres. Roque Sáenz Peña, Chaco, Argentina
| | - G Bovi Mitre
- Grupo INQA (Investigación Química Aplicada) Facultad de Ciencias Agrarias, Universidad Nacional de Jujuy, Alberdi 47, piso 1, San Salvador de Jujuy, Jujuy CP 4600, Argentina
| | - E de Titto
- Dirección Nacional de Determinantes de la Salud e Investigación, Ministerio de Salud de la Nación, Av. 9 de Julio 1925, C1073ABA Ciudad Autónoma de Buenos Aires, Argentina
| | - E C Villaamil Lepori
- Cátedra de Toxicología y Química Legal, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Junín 956, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
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Cocker R, Chau K, Gimenez C, Khalbuss WE. Role of FNA cytology with cell block in the diagnosis of papillary squamous cell carcinoma of the upper aero-digestive tract: case report. Cytopathology 2014; 26:390-1. [PMID: 25303677 DOI: 10.1111/cyt.12209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R Cocker
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - K Chau
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - C Gimenez
- North Shore-Long Island Jewish Health System, Lake Success, NY, USA
| | - W E Khalbuss
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Jimenez-Macedo A, Garcia-Guixé E, Escudero T, Colls P, Munné S, Gimenez C, Sandalinas M. O4 Preimplantation Genetic Diagnosis (PGD) for chromosomal rearrangements (CR) using arrays of comparative genome hybridization (aCGH). Risk assessment depending on the type of CR, the maternal age and the sex of the carrier. Reprod Biomed Online 2012. [DOI: 10.1016/s1472-6483(12)60209-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sertyel S, Kolankaya A, Yigit A, Cengiz F, Kunacaf G, Akman MA, Gurgan T, Yu B, DeCherney A, Segars J, Russanova V, Howard B, Serafini P, Kimati C, Hassun P, Cuzzi J, Peres M, Riboldi M, Gomes C, Fettback P, Alegretti J, motta E, Lappa C, Ottolini CS, Summers MC, Sage K, Rogers S, Griffin DK, Handyside AH, Thornhill AR, Ubaldi F, Capalbo A, Wright G, Elliott T, Maggiulli R, Rienzi L, Nagy ZP, Cinar Yapan C, Beyazyurek C, Ekmekci CG, Altin G, Yesil M, Yelke H, Kahraman S, Khalil M, Rittenberg V, Khalaf Y, El-toukhy T, Alvaro Mercadal B, Imbert R, Demeestere I, De Leener A, Englert Y, Costagliola S, Delbaere A, Zimmermann B, Ryan A, Baner J, Gemelos G, Dodd M, Rabinowitz M, Hill M, Sandalinas M, Garcia-Guixe E, Jimenez-Macedo A, Gimenez C, Hill M, Wemmer N, Potter D, Keller J, Gemelos G, Rabinowitz M, Cater E, Lynch C, Jenner L, Berrisford K, Campbell A, Keown N, Rouse H, Craig A, Fishel S, Palomares AR, Lendinez Ramirez AM, Martinez F, Ruiz Galdon M, Reyes Engel A, Mamas T, Xanthopoulou L, Heath C, Doshi A, Serhal P, SenGupta SB, Plaza S, Templin C, Saguet F, Claustres M, Girardet A, Rienzi L, Biricik A, Capalbo A, Colamaria S, Bono S, Spizzichino L, Ubaldi F, Fiorentino F, Hassun P, Alegretti JR, Kimati C, Barros B, Riboldi M, Cuzzi J, Motta ELA, Serafini P, Tulay P, Naja RP, Cascales-Roman O, Cawood S, Doshi A, Serhal P, SenGupta SB, Montjean D, Ravel C, Belloc S, Cohen-Bacrie P, Bashamboo A, McElreavey K, Benkhalifa M, Filippini G, Radovanovic J, Spalvieri S, Marabella D, Timperi P, Suter T, Jemec M, Traversa M, Marshall J, Leigh D, McArthur S, Zhang L, Yilmaz A, Zhang XY, Son WY, Holzer H, Ao A, Horcajadas JA, Munne S, Fisher J, Ketterson K, Wells D, Bisignano A, Rubio C, Mateu E, Milan M, Mercader A, Bosch E, Labarta E, Crespo J, Remohi J, Simon C, Pellicer A, Mercader A, Garrido N, Rubio C, Buendia P, Delgado A, Escrich L, Poo ME, Simon C, Held K, Baukloh V, Arps S, Wittmann ST, Petrussa L, Van de Velde H, De Rycke M, Beyazyurek C, Ekmekci CG, Ajredin N, Cinar Yapan C, Tac HA, Yelke HK, Altin G, Kahraman S, Basile N, Bronet F, Nogales MC, Ariza M, Martinez E, Linan A, Gaytan A, Meseguer M, Christopikou D, Tsorva E, Economou K, Davies S, Mastrominas M, Handyside AH, Avo Santos M, M. Lens S, C. Fauser B, S. E. Laven J, B. Baart E, Nakano T, Akamatsu Y, Sato M, Hashimoto S, Maezawa T, Himeno T, Ohnishi Y, Inoue T, Ito K, Nakaoka Y, Morimoto Y, Al Sharif J, Alhalabi M, Abou Alchamat G, Madania A, Khatib A, Kinj M, Monem F, Mahayri Z, Ajlouni A, Othman A, Chung JT, Son WY, Zhang XY, Ao A, Tan SL, Holzer H, Burnik Papler T, Fon Tacer K, Devjak R, Juvan P, Virant-Klun I, Vrtacnik Bokal E, Zheng HY, Chen SL, Chen X, Tang Y, Li L, Ye DS, Yang XH, Eichenlaub-Ritter U, Trapphoff T, Hastreiter S, Haaf T, Asada H, Maekawa R, Tamura I, Tamura H, Sugino N, Zakharova E, Zaletova V, Krivokharchenko I, Ata B, Kaplan B, Danzer H, Glassner M, Opsahl M, Tan SL, Munne S. REPRODUCTIVE (EPI) GENETICS. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brezina P, Nguyen KHD, Benner AT, Du L, Ross R, Barker A, Anchan RM, Richter K, Kearns WG, Kirkegaard K, Hindkjaer J, Ingerslev HJ, Garcia-Guixe E, Jimenez-Macedo A, Arjona C, Gimenez C, Sandalinas M, Mizutani E, Suzumori N, Ozaki Y, Oseto K, Yamada-Namikawa C, Nakanishi M, Sugiura-Ogasawara M, Borges E, Figueira RCS, Braga DPAF, Pasqualetto FF, Setti AS, Iaconelli A, Tolmacheva EN, Kashevarova AA, Sukhanova NN, Lebedev IN. SELECTED ORAL COMMUNICATION SESSION, SESSION 36: ANEUPLOIDY, Tuesday 5 July 2011 10:00 - 11:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Iaconelli A, Figueira RCS, Setti AS, Braga DPAF, Pasqualotto FF, Borges E, Palomares AR, Lendinez Ramirez AM, Perez-Nevot B, Martinez F, Jimenez A, Ruiz Galdon M, Reyes-Engel A, Sandalinas M, Garcia-Guixe E, Jimenez-Macedo A, Arjona C, Colls P, Escudero T, Munne S, Gimenez C, Gleicher N, Weghofer A, Barad DH, Rongioletti M, Papa F, Majolini MB, Panetta V, Luciano A, Scotaccia P, Cesaretti S, Vaccarella C, Liumbruno GM. SELECTED ORAL COMMUNICATION SESSION, SESSION 48: REPRODUCTIVE GENETICS, Tuesday 5 July 2011 15:15 - 16:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rubio C, Gimenez C, Fernandez E, Vendrell X, Velilla E, Parriego M, Rodrigo L. The importance of good practice in preimplantation genetic screening: critical viewpoints. Hum Reprod 2009; 24:2045-7. [DOI: 10.1093/humrep/dep188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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del Río F, Brassesco A, Cairó O, Rovira S, Prats L, Rodríguez M, Bernabéu R, López-Teijón M, Garcí-Ochoa C, Aísa S, Ruiz M, Murillo B, González-Viejo L, Gimenez C, Fernández S, Maqueda A, Gómez M, Brassesco M. 5.005 Morphological embryo selection: do we work correctly with recurrent miscarriage couples? Reprod Biomed Online 2008. [DOI: 10.1016/s1472-6483(10)61392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ingelmo PM, Gelsumino C, Acosta AP, Lopez V, Gimenez C, Halac A, Lira P, Schon A, Spagnolo B, Pignataro A, Nunez G, Gamboa M, Buquicchio I, Astuto M, Fumagalli R. Epidural analgesia in children: planning, organization and development of a new program. Minerva Anestesiol 2007; 73:575-585. [PMID: 17952030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in the program. The program provided training to the entire staff, control and record of pain treatment and its consequences, 24 h a day availability of anesthesia staff and standard polices and procedures. RESULTS One hundred fifty children under 16 years of age (median age 11 years, median weight 35 kg) were included in the program during the first 18 months. The median of maximum pain reported during activity was 1 (interquartile range 1 to 4 points) using the Visual Analogue Scale (VAS) or Objective Pain Scale (OPS). Eighty seven children (CI 95% 50% to 67%) presented with postoperative nausea and vomiting, urinary retention, itching, motor blockade or sedation. No patient presented with respiratory depression, hypotension, local anaesthetic toxicity, epidural catheter related infection or death during the program evaluation. The postoperative care program enabled a 98-day reduction in treatment in the intensive care unit. CONCLUSION The safe use of pediatric epidural analgesia in general wards may require the careful selection of patients, systematic assessment by trained personnel, training of medical and nursing personnel, clear distribution of responsibilities, use of printed indications, systematic record of pain, sedation and complications, information and education of patients and parents, supply of systems for airway resuscitation and management and continuous quality control and revision of the methods.
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Affiliation(s)
- P M Ingelmo
- Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital of Monza, Milano Bicocca University, Milan, Italy.
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LeCaer H, Fournel P, Jullian H, Chouaid C, Letreut J, Thomas P, Paillotin D, Perol M, Gimenez C, Vergnenegre A. An open multicenter phase II trial of docetaxel–gemcitabine in Charlson score and performance status (PS) selected elderly patients with stage IIIB pleura/IV non-small-cell lung cancer (NSCLC): The GFPC 02-02a study. Crit Rev Oncol Hematol 2007; 64:73-81. [PMID: 17669664 DOI: 10.1016/j.critrevonc.2007.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 02/27/2007] [Accepted: 06/12/2007] [Indexed: 12/27/2022] Open
Abstract
UNLABELLED The aim of this study was to determine the impact of patient selection based on age, comorbidity and performance status on the efficacy of platinum-free combination therapy on non-small-cell lung cancer after 65 years of age. We analyzed the overall response rate, the median survival time, the 1-year survival rate, toxicity and quality of life after one to three 6-week cycles of docetaxel 30mg/m(2) weekly and gemcitabine 900mg/m(2) at weeks 1, 2, 4 and 5. Fifty patients (median age 73.7 years) were eligible. The mean number of comorbid conditions per patient was 0.8 [Balducci L. Lung cancer and aging. ASCO 2005. Educational book. p. 587-91; Piquet J, Blanchon F, Grivaux M, et al. Primary bronchial carcinoma in elderly subjects in France. Rev Mal Respir 2003;20:691-9; Jatoi A, Hillman S, Stella P, et al. Should elderly non-small-cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the North Central Cancer Treatment Group. J Clin Oncol 2005;23:9113-9; Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist 2000;5:224-37]. Forty-five patients were assessable: 17 (34%) had an objective response, 18 (36%) had stable disease and 10 progressed (20%). The median survival time was 7 months and the 1-year survival rate 23.5%. The main grade III-IV adverse event was neutropenia (32% of patients). CONCLUSION Platinum-free dual-agent chemotherapy gives similar results in patients over 65, selected on the basis of their precise age and comorbidity, to that reported in younger subjects.
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Affiliation(s)
- H LeCaer
- Centre Hospitalier, Draguignan, France.
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Greillier L, Gimenez C, Tchouhadjian C, Fraticelli A, Barlési F, Astoul P. Prise en charge des pneumothorax et des pleurésies par l’utilisation de drains mis en place par la technique de Seldinger. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91686-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Greillier L, Gimenez C, Tchouhadjian C, Fraticelli A, Barlési F, Astoul P. Les patients présentant une pleurésie ne s’améliorent pas toujours après une ponction pleurale évacuatrice ; ce geste peuts’accompagner de symptômes (oppression, inconfort thoracique) conduisant à arrêterl’examen. La mesure de la pression pleuraleau cours de ce geste doit-elle se généraliser ? Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91688-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Gimenez C, Tchouhadjian C, Fraticelli A, Barlési F, Astoul P. La prise en charge simplifiée du pneumothorax spontané primaire par un dispositif connectant un catheter et une valve de Heimlich est possible en ambulatoire. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91683-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Gimenez C, Tchouhadjian C, Fraticelli A, Barlési F, Astoul P. Prise en charge des pleurésies néoplasiques par insertion d’un catheter pleural tunnellisé. Une approche ambulatoire exclusive ? Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91687-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Gimenez C, Tchouhadjian C, Fraticelli A, Barlési F, Astoul P. Le vécu d’un épisode de pneumothorax et les souhaits des patients suivis pour lymphangioléiomyomatose sont différents de ceux des médecins et doivent être pris en compte dans la prise en charge. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)91685-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vergnenegre A, Combescure C, Fournel P, Bayle S, Gimenez C, Souquet PJ, Lena H, Perol M, Delhoume JY. Cost-minimization analysis of a phase III trial comparing concurrent versus sequential radiochemotherapy for locally advanced non-small-cell lung cancer (GFPC-GLOT 95–01). Ann Oncol 2006; 17:1269-74. [PMID: 16728480 DOI: 10.1093/annonc/mdl100] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We conducted an economic analysis of a phase III clinical trial comparing sequential radiochemotherapy (RT-CT) with concurrent RT-CT in patients with locally advanced non-small-cell lung cancer. PATIENTS AND METHODS The trial was a randomized multicenter study comparing three cycles of chemotherapy (arm A) followed by radiotherapy against an RT-CT combination (two cycles of platinum etoposide) followed by two cycles of platinum-vinorelbine (arm B). The economic analysis adopted the payer's perspective and only included direct costs. Costs (euro, 1996-2003) were recorded until the cut-off date. A cost minimization analysis and a sensitivity analysis were carried out. RESULTS Data from 173 patients were used in the economic study. Protocol costs tended to be higher in arm B, while relapse costs were significantly higher in arm A. The total number of hospital days was higher in arm B. The average total cost per patient was euro16,074 in arm A and euro15,245 in arm B (P=0.15). The cost minimization analysis favored arm B. This advantage persisted in the sensitivity analysis. CONCLUSIONS Concurrent RT-CT was not the more costly strategy in this phase III trial, despite lengthier hospitalization for toxicity. Other studies of similar design are needed to confirm these results in future randomized trials.
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Cortot AB, Gerinière L, Robinet G, Breton JL, Corre R, Falchero L, Berard H, Gimenez C, Chavaillon JM, Perol M, Bombaron P, Mercier C, Souquet PJ. Phase II trial of temozolomide and cisplatin followed by whole brain radiotherapy in non-small-cell lung cancer patients with brain metastases: a GLOT-GFPC study. Ann Oncol 2006; 17:1412-7. [PMID: 16790516 DOI: 10.1093/annonc/mdl146] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Brain metastases (BM) considerably worsen the prognosis of non-small-cell lung cancer (NSCLC) patients. The usefulness and choice of chemotherapy remain uncertain in this indication since these patients are excluded from most clinical trials. We conducted a phase II study to determine the efficacy and tolerability of up-front chemotherapy with association of temozolomide and cisplatin in NSCLC patients with BM. PATIENTS AND METHODS Fifty NSCLC patients with BM received temozolomide (200 mg/m(2)/day for 5 days every 28 days) and cisplatin (75 mg/m(2) at day 1 of each cycle), up to six cycles, followed by whole brain radiotherapy (WBRT). An evaluation was carried out every two cycles and after WBRT. WBRT was performed earlier in case of progressive disease at any time or stable disease after cycle 4. RESULTS Eight objective responses were achieved (16%). Overall median survival was 5 months. Median time to progression was 2.3 months. Ten patients (20%) presented a grade 3/4 neutropenia and 11 patients (22%) presented a grade 3/4 thrombopenia. CONCLUSION This study demonstrates a lack of efficacy of up-front chemotherapy with association of temozolomide and cisplatin in these patients. Nevertheless, it supports the feasibility of chemotherapy before brain radiotherapy in NSCLC patients with BM.
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Affiliation(s)
- A B Cortot
- Service de Pneumologie, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
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Thompson R, Martínez C, Fernandez M, Lopez-Toral J, Gallardo M, Gimenez C. MANAGEMENT FACTORS CONTRIBUTING TO NITRATE LEACHING LOSS FROM A GREENHOUSE-BASED INTENSIVE VEGETABLE PRODUCTION SYSTEM. ACTA ACUST UNITED AC 2006. [DOI: 10.17660/actahortic.2006.700.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Le Caer H, Gimenez C, Chouaid C, Jullian H, Le Treut J, Bombaron P, Geriniere L, Hominal S, Dominique P, Auliac J. P-548 A multicenter phase II study of docetaxel/gemcitabine weekly inadvanced non-small cell lung cancer (NSCLC) in elderly and/or poor performance status (PS) patients (pts): Preliminary results of the 02-02 Groupe Français de Pneumo-Cancérologie (GFPC) study. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81041-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vergnenègre A, Chouaïd C, Corre R, Gimenez C, Vernejoux J, Bérard H, Fournel P, Arpin D, David P, Preux P. P-590 A randomized phase II trial of early change of a chemotherapeuticdoublet versus four cycles of chemotherapy in advanced non small cell lung cancer (NSCLC): Interim analysis of the 03-01 Groupe Français de Pneumo-Cancérologie (GFPC) study. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81083-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Chez l’animal, les anti-inflammatoires non stéroïdiens en post-opératoire nuisent à la qualité des pleurodèses par abrasion mécanique. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72984-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Pathologie pleurale. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Radiothérapie prophylactique sur les points de ponction dans les mésothéliomes pleuraux malins : une dose unique de 10 Grays ne suffit pas. Le régime de 21 Grays en 3 fractions reste de mise. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Le traitement multimodal du mésothéliome pleural reste d’actualité mais des essais multicentriques demeurent nécessaires pour en confirmer le bien-fondé. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72979-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Le Caer H, Gimenez C, Fournel P, Chouaid C, Robinet G, Jullian H, Vergnenegre A, Bayle S, Barlesi F, Barriere JR. A multicenter phase II study of docetaxel (D) or docetaxel/gemcitabine (G) weekly in advanced non-small cell lung cancer (NSCLC) in elderly and/or poor performance status (PS) patients (pts).(GFPC 0202). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. Le Caer
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - C. Gimenez
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - P. Fournel
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - C. Chouaid
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - G. Robinet
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - H. Jullian
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - A. Vergnenegre
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - S. Bayle
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - F. Barlesi
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
| | - J. R. Barriere
- Ctr Hospitalier, Draguignan, France; Hôpital Ste Marguerite, Marseille, France; Hôpital Nord, Saint Etienne, France; Hôpital Saint Antoine, Paris, France; CHU Morvan, Brest, France; Ctr Hospitalier, Martigues, France; Hôpital du Cluzeau, Limoges, France
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. L’instillation intrapleurale de streptokinase est-elle utile dans la prise en charge des pleurésies purulentes ? Dans cette étude randomisée, elle a diminué le recours à la chirurgie. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72981-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Lors d’une pleurodèse, le talc non calibré induit davantage d’inflammation pulmonaire et systémique que la tétracycline ou le talc calibré. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72983-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Greillier L, Barlesi F, Fraticelli A, Gimenez C, Tchouhadjian C, Astoul P. Dans 4,5 % des cancers bronchiques non à petites cellules opérés, même sans épanchement pleural initial, le lavage pleural per-opératoire détecte des cellules malignes, ce qui grève le pronostic. Rev Mal Respir 2005. [DOI: 10.1016/s0761-8425(05)72978-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ratsimanohatra H, Barlesi F, Doddoli C, Robitail S, Gimenez C, Kleisbauer JP, Astoul P. 153Samarium-EDTMP et contrôle de la douleur liée aux métastases osseuses des cancers bronchiques. Rev Mal Respir 2005; 22:317-20. [PMID: 16092169 DOI: 10.1016/s0761-8425(05)85484-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The treatment of bone metastasis from lung cancer is palliative in nature with elimination of pain being the primary goal. Management is based on pharmacologicalmethods (steroids, morphine, and pamidronate) and radiotherapy. However, other treatments have been developed including the systemic radiopharmaceutical 153Sm-EDTMP. CASE REPORTS We report data from 6 lung cancer patients with bone metastases treated with 153Sm-EDTMP. Demographic and therapeutic data, pain evaluation by visual analogue scale (VAS) and change in opioid analgesia requirements (expressed as intravenous morphine equivalent) as well as survival were studied. Pain associated with bone metastasis (median VAS = 8 [7-9], median morphine dose = 167 mg [100-800 mg]) did not significantly improve (median VAS after 153Sm-EDTMP = 8.5 [5-10], median morphine dose after 153Sm-EDTMP = 185 mg [30-2 200 mg]) in this group of patients. CONCLUSION Our results combined with current data in the literature concerning the use of this treatment in the treatment of bone pain associated with metastatic lung cancer suggest that at present its use cannot be recommended outside the context of clinical of clinical trials.
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Affiliation(s)
- H Ratsimanohatra
- Service des Maladies Respiratoires, Hôpital Général de Befelatanana, CHU Antananarivo, Madagascar
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Barlési F, Gimenez C, Torre JP, Doddoli C, Mancini J, Greillier L, Roux F, Kleisbauer JP. Valor prognóstico da associação de Cyfra 21-1, CEA e NSE em doentes com carcinoma pulmonar não de pequenas células em estádio avançado. Revista Portuguesa de Pneumologia 2005. [DOI: 10.1016/s0873-2159(15)30491-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
INTRODUCTION Paraneoplastic syndromes sometimes lead to the discovery of an intrathoracic tumour, notably small cell lung cancer (SCLC). MATERIALS AND METHODS We report the case of a patient presenting with a paraneoplastic syndrome characterised by disordered higher functions and convulsions, representing a paraneoplastic encephalo-myelitis (PEM). This PEM led to the diagnosis of SCLC. The diagnostic features and progress of the PEM are discussed. CONCLUSION Recognition of PEM allows the diagnosis and early treatment of the underlying cancer, strongly influencing the prognosis, particularly in SCLC.
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Affiliation(s)
- J Rakotomizao
- Service des Maladies Respiratoires, Hôpital Général de Befelatanana, CHU Antananarivo, Madagascar
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. L’adjonction de pemetrexed (Alimta®) au cisplatine améliore la survie du mésothéliome pleural. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. Quelle est la place de la « mini-thoracoscopie » ? Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71981-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. Ponction pleurale : un guidage par échographie permet-il de diminuer les complications ? Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. Devant un mésothéliome potentiellement résécable, faut-il préalablement faire une médiastinoscopie ? Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71983-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. Biopsies pleurales percutanées : un radioguidage par tomodensitométrie multiplie par deux la sensibilité de la méthode. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71980-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. Pathologie pleurale. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71978-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Greillier L, Fraticelli A, Barlési F, Gimenez C, Astoul P. La recherche de BK dans une expectoration induite peut être utile au diagnostic de tuberculose pleurale. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71986-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Feille F, Bayard C, Bonal M, Gimenez C, Giraud F, Lefebvre V, Nogues M, Piens-Bordenave S, Philippe J, Pinaud J, Roncier M, Ruggiu M, Tello V. Mise en place de la pluridisciplinarité dans un service de santé au travail. ARCH MAL PROF ENVIRO 2004. [DOI: 10.1016/s1775-8785(04)93362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gimenez C, Blatier C. Étude de l'agressivité physique chez le jeune enfant : comparaison d'une population française et d'une population canadienne. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.neurenf.2003.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Robinet G, Breton J, Lena H, Geriniere L, Gimenez C, Falchero L, Berard H, Bombaron P, Letreut J, Perol M, Souquet P. 42 Essai de phase II de l’association cisplatine-témozolomide dans les métastases cérébrales des cancers bronchiques non à petites cellules (CNPC). Etude glot-GFPC. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71668-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fraticelli A, Robaglia A, Gimenez C, Cau P, Monjanel-Mouterde S, Astoul P. [An experimental study on the systemic distribution of calibrated talc after intra-pleural injection]. Rev Mal Respir 2003; 20:881-8. [PMID: 14743089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Among the agents used to produce pleural symphysis talc is the most effective and least expensive. However, its use is controversial on account of the description of respiratory complications associated with subsequent systemic spread of the talc particles. This hypothesis rests on clinical and experimental observations of talc particles in the viscera. However, all talc preparations are not identical and this extra-pleural spread could be dependent on particle size. This experimental study was undertaken to determine whether there was systemic spread of a calibrated talc preparation used routinely in clinical practice following intra-pleural administration in rats. METHODS 48 rats received 20 mg (11 rats) and 40 mg (33 rats) of calibrated talc suspended in 1 ml of physiological saline by intra-pleural injection. The animals were randomised for sacrifice at 24 hours (22 rats) and 72 hours (22 rats) after the injection. The lungs, parietal pleura, diaphragm, liver, spleen, pericardium, brain and blood were examined by light microscopy and polarised light to search for bi-refringent particles. RESULTS No deaths occurred during the procedure. At the time of sacrifice no pleural symphysis was seen. In 5 animals some talc particles were seen in the extra-thoracic organs: in the liver in 3 in the spleen in 1 and one particle in the brain of one animal examined by electron microscopy. No talc particles were found in the blood. CONCLUSIONS Intra-pleural injection of calibrated talc, (Steritalc-Novatech-Plan de Grasse-France) has a weak systemic spread in > small animals. These results may be related to the diameter of the talc particles used (mean 33.6 microns; median 31.3 microns). The hypothesis that systemic spread is influenced by the diameter of the talc particles needs to be supported by experimental studies using talc particles of smaller diameter in order to compare the systemic distribution of the different preparations.
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Affiliation(s)
- A Fraticelli
- Département des Maladies Respiratoires, Hôpital Sainte Marguerite, Marseille, France
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Barlési F, Dissard-Barriol E, Gimenez C, Doddoli C, Greillier L, Kleisbauer JP. [Tolerance of fiberoptic bronchoscopy by self-administered questionnaire: in the words of the patients]. Rev Mal Respir 2003; 20:335-40. [PMID: 12910107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Fibreoptic bronchoscopy is currently undertaken by the majority of respiratory physicians, but under varying conditions. Though complications are rare the tolerance of this examination is sometimes poor, particularly when it is performed under local anaesthesia. The undesirable effects may reduce the value of the examination as well as causing discomfort for the patient. METHODS A prospective study of the tolerance of the endoscopic examination was made on 100 consecutive patients by self-administered questionnaire. RESULTS There were no major and 7 minor complications (7%). 45% of the patients were anxious but the experience of the operator tended to reassure them (p=0.07). 30% of the patients reported some pain, which tended to be exacerbated by anxiety (44% vs 18%, p=0.008) and the supine position (57% vs 43%, p=0.047). 37% of patients reported nausea, and 50% dyspnoea, without any significant predictive factor. 79% would agree to a repeat examination under the same conditions and 92% said that they had received information appropriate to the examination undergone. CONCLUSION The tolerance of fibreoptic bronchoscopy under local anaesthesia is poor and perhaps overestimated by respiratory physicians. Patient information is essential. A national enquiry could lead to the standardisation of techniques.
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Affiliation(s)
- F Barlési
- Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte-Marguerite, Marseille.
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Barlési F, Doddoli C, Gimenez C, Greillier L, Lima G, Kleisbauer JP. [Acute pulmonary toxicity due to gemcitabine: a role for asbestos exposure?]. Rev Mal Respir 2003; 20:201-6. [PMID: 12844017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
INTRODUCTION Gemcitabine is an important drug in the treatment of non-small cell lung cancer. Myelosuppression is the most common toxic effect but its use sometimes leads to severe pulmonary toxicity by means of diffuse alveolar damage or sub-acute interstitial pneumonitis. METHODS A retrospective study was made of all the patients treated in our department with this drug, alone or in combination. Episodes of acute dyspnoea during the course of chemotherapy were identified, and data were collected concerning the past history, the illness and the treatment in patients who had developed a respiratory failure attributable to gemcitabine. RESULTS 312 patients had been treated with gemcitabine over a 5 year period and 18 had developed episodes of acute dyspnoea, of which 6 (1.9%) were attributed to the drug itself. Of these patients 4 had notifiable industrial disease (no. 30bis) secondary to asbestos exposure (odds ratio=85, 95% confidence interval 13-546) and 5 were active smokers. The possible role of intracellular ATP pool depletion secondary to asbestos exposure or smoking as a predisposing factor in the development of gemcitabine pulmonary toxicity is discussed. CONCLUSION Smoking and asbestos exposure should be taken into account in future studies of gemcitabine pulmonary toxicity.
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Affiliation(s)
- F Barlési
- Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte-Marguerite, Marseille, France.
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