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Vigan M.,Besancon University Hospital Center
European Journal of Dermatology | Year: 2010

Essential oils are complex mixtures of substances from vegetable matter, the definition of which is based on their method of extraction. They are characterized by their ambivalence, their ambiguity and their disparity: plant families from which essential oils are extracted are numerous; the composition of each essential oil depends not only on the family but also on the part of the plant from which it is extracted, and sometimes on the soil where the plant grows, or even on the time of the harvest. Gas chromatography is therefore necessary to characterize an essential oil. Essential oils can be found in cosmetics, in drugs, and in food. They are natural substances, but natural is not synonymous with harmless. Evaluation of the toxicity of essential oils and European regulation are underway.


Wendling D.,Besancon University Hospital Center
Expert Opinion on Emerging Drugs | Year: 2013

New emerging drugs in the treatment of ankylosing spondylitis (AS), and spondyloarthritis in general, should be compared to anti-TNF agents, which provided clear evidence of efficacy in these conditions. To date, other biologic agents used in rheumatoid arthritis failed to demonstrate efficacy in AS, even in anti-TNF naïve patients. Some new potential options may target cytokines such as IL-17, or molecules involved in entheseal ossification or signaling pathways, but need confirmatory evaluation. © 2013 Informa UK, Ltd.


Optimization of chemotherapy effectiveness in metastatic colorectal cancers (mCRC) is a major endpoint to enhance the possibility of curative intent surgery. FOLFIRI3 has shown promising results as second-line chemotherapy for mCRC patients previously exposed to oxaliplatin. The clinical efficacy of FOLFIRI3 was never determined in association with bevacizumab in non-previously treated mCRC patients. We conducted a phase II clinical trial to characterize the response rate and toxicity profile of FOLFIRI3-bevacizumab as initial treatment for mCRC. Sixty-one patients enrolled in 3 investigation centers were treated with FOLFIRI3-bevacizumab (median of 10 cycles) followed by a maintenance therapy combining bevacizumab and capecitabine. Levels of plasma angiopoietin-2 (Ang-2) were measured by enzyme-linked immunosorbent assay at baseline. Overall response rate (ORR) was 66.7% (8% of complete and 58% of partial responses). The disease control rate was 91.7%. After a median time of follow-up of 46.7 months, 56 patients (92%) had progressed or died. The median progression free survival (PFS) was 12.7 months (95% confidence interval (CI) 9.7-15.8 months). The median overall survival (OS) was 24.5 months (95% CI: 10.6-38.3 months). Twenty-one patients underwent curative intent-surgery including 4 patients with disease initially classified as unresectable. Most common grade III-IV toxicities were diarrhea (15%), neutropenia (13%), asthenia (10%), and infections (4%). Hypertension-related medications needed to be increased in 3 patients. In multivariate analysis, surgery of metastases and Ang-2 levels were the only independent prognostic factors for PFS and OS. Indeed, baseline level of Ang-2 above 5 ng/mL was confirmed as an independent prognostic factor for progression free survival (HR = 0.357; 95% CI: 0.168-0.76, p = 0.005) and overall survival (HR = 0.226; 95% CI: 0.098-0.53, p = 0.0002). As front-line therapy, FOLFIRI-3-bevacizumab is associated with an acceptable toxicity and induced promising objective response rates. However, unfavorable clinical outcomes were observed in patients with high levels of angiopoietin-2.


Pauchot J.,Besancon University Hospital Center
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] | Year: 2013

In oncology, dermal equivalent may be indicated to cover losses of substance related to skin tumors or after the removal of skin flaps. To report our experience of two dermal equivalents, Matriderm 1 mm with a one-stage graft (DE1) and Integra DL with a two-stage graft (DE2) in oncology. Retrospective, single-center study involving 16 patients. Sixteen patients received dermal equivalents as an alternative to flaps (7 cases), over tendinous areas (7 cases), and for cosmetic purposes (2 cases). Twelve patients received DE1 and four DE2. Wound healing times with DE1 were 4 weeks less than those with DE2. Three cases of infection were noted with DE2. The use of dermal equivalents as an alternative to skin flaps was effective, and no adhesions were found over the tendinous areas. The learning curve, the two-stage graft required with DE2, and not using a vacuum-assisted closure system can explain the high infection rate. The use of dermal equivalents is particularly indicated in the treatment of skin defect in oncology. The possibility of a one-stage graft with DE1 and combination with negative pressure therapy is beneficial. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.


Grant
Agency: Cordis | Branch: FP7 | Program: CP | Phase: ICT-2011.3.5 | Award Amount: 4.46M | Year: 2012

Skin cancer is the most commonly diagnosed type of cancer. Its early diagnosis is essential since it can be treated more effectively when detected earlier. New diagnostics aids are emerging including the recent techniques of optical coherence tomography (OCT) which permits non-invasive 3D optical biopsies of skin, improving patients quality of life. Nevertheless, the existing bulk systems are expensive (100 k), only affordable at the Hospital and thus, not sufficiently used by physicians or dermatologists as an early diagnosis tool.\nThe goal of VIAMOS is to benefit from advanced MOEMS technologies, enabling a new generation of miniature instruments. The challenge is to provide handheld, low-cost, fully parallel spectral domain miniature OCT devices (10 times cheaper, 150 times smaller), adapted for early diagnosis of cutaneous pathologies. VIAMOS will lean on the experience and results fostered from a previous European collaborative project, diffusing the technology to medical diagnostic applications. The consequence will be a significant upgrade adding new features such as heterodyne detection and integrated swept source.\nThanks to its ability to deliver high-resolution 3D topography of skin with multifunctional modules (e.g. polarization sensitive cartography), VIAMOS will propose an OCT microsystem able to revolutionize the field of microscopes for dermatology imaging.\nTo match these objectives, VIAMOS brings together an experienced consortium made of 2 academic institutions (UFC-P5 and USTUTT), 3 research institutes (VTT, FhG and CSEM) and 2 industrials (DERM and STAT), covering MEMS & MOEMS, photonics & OCT, microscopy, system integration and dermatology. A unique team of transverse expertise is gathered in VIAMOS to design and demonstrate a miniature solution for in vivo 3D skin imaging to further address the early diagnosis of cutaneous pathologies that will potentially benefit millions of people worldwide.

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