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Biran V.,Service de neonatologie | Biran V.,French Institute of Health and Medical Research | Gourrier E.,Center Hospitalier Of Meaux | Cimerman P.,Center National Of Ressources Of Lutte Contre La Douleur | And 3 more authors.
Pediatrics | Year: 2011

OBJECTIVE: The goal of this study was to compare the analgesic effect of sucrose with that of the combination of sucrose and the local anesthetic cream EMLA during venipuncture in preterm neonates. METHODS: This randomized, double-blind prospective study included infants younger than 37 weeks' gestational age during 1 routine venipuncture for blood sampling. Each child randomly received either sucrose plus application of a placebo cream (S group) or sucrose plus EMLA cream (S+E group) before venipuncture. Venipuncture-induced pain was assessed through videotapes of the procedures by using the Douleur Aiguë Nouveau-né (DAN) behavioral scale. Pain was assessed at 2 phases: during venipuncture (from needle introduction to its removal) and during the recovery period (30 seconds after needle removal). Pain scores over time and between treatments were compared by using repeated-measures analysis of variance. RESULTS: The study included 76 children (37 in the S group, 39 in the S+E group). Mean (SD) DAN pain scores for the S group and the S+E group were 7.7 (2.1) and 6.4 (2.5), respectively, during venipuncture and 7.1 (2.8) and 5.7 (3.3) during the postinjection period. A significant time and treatment effect in favor of the S+E group was observed. CONCLUSION: The combination of sucrose and EMLA cream revealed a higher analgesic effect than sucrose alone during venipuncture in these preterm infants. Copyright © 2011 by the American Academy of Pediatrics. Source

To determine the prevalence of the latent tuberculosis infection (LTBI) among health care workers (HCW) of the emergency ward of Meaux hospital, by comparing it with two witnesses units: the orthopaedic surgery ward (referral service to low risk) and the respiratory ward (referral service to high risk). From July to December 2008, on a voluntary basis, anonymised blood samples of any HCW of the three departments were carried out by the occupational health service. Determination of interferon gamma was released by the test "QuantiFERON-TB Gold" (QFT). Of the 137 eligible subject sampled, 16 had a positive QFT test: nine in the emergency ward, six in the respiratory ward and one in the orthopaedic surgery ward. The proportion of HCW with a positive QFT test was not significantly different between the three wards. This study shows that HCWs of the emergency ward of the Meaux hospital are not working in a department where the risk of LTBI is high. Our study shows that, in a territory of health where the incidence of the tuberculosis disease is superior to the national average, the emergency department of Meaux hospital does not belong to an area at high risk of LTBI. It underlines the interest of QFT test for the screening of LTBI among vaccinated persons. Copyright © 2011 Elsevier Masson SAS. All rights reserved. Source

Locher C.,Center Hospitalier Of Meaux | Pourel N.,Institute Sainte Catherine | Marin B.,Unite Fonctionnelle de Recherche | Vergnenegre A.,Center Hospitalier Of Limoges
Revue des Maladies Respiratoires | Year: 2011

A phase II study of weekly cisplatine plus oral vinorelbine with concomittant radiotherapy in non-dependent elderly patients with localized inoperable non small cell lung carcinoma (Essai GFPC 08-06, Raccosa). Background.- Non small cell lung cancer (NSCLC) in elderly patients is an important problem because of the increasing incidence of NSCLC and the aging of the population. Elderly patients constitute a heterogeneous population including a significant group of relatively fit patients who ought to benefit from the conventional treatment. The standard treatment for a locally advanced NSCLC (inoperable IIIA and IIIB) is concomitant radiochemotherapy, however studies evaluating this treatment to the old subject are few. Methods.- This phase II study aims to evaluate tolerance of concomitant radiochemotherapy in fit elderly patients (more than 70 years old) with locally advanced NSCLC (inoperable IIIAN2 or IIIB). The treatment is oral vinorelbine (30mg/m2 per week) and intravenous cisplatine (30mg/m2 per week) during 6 weeks in conjunction with radiotherapy (66 Gy, 33 fraction, six and a half weeks). The main criterion of evaluation is acute toxicity. Late toxicity, quality of life, global response, time to progression and overall survival will also be estimated. With a Simons optimal plan in two steps, the total number of patients to be included is 59 with an intermediate analysis after the inclusion of 19 patients. Expected results.- Our study aims to demonstrate that fit elderly patients can benefit from concomitant radiochemotherapy. It will permit an improvement in the care available for fit elderly patients with locally advanced NSCLC by allowing them to benefit from the reference treatment. © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved. Source

Fukui S.,Clinique Alleray Labrouste | Paraskevas N.,Evgenideion Hospital | Soury P.,Hopital Prive de LOuest Parisien | Gigou F.,Center Hospitalier Of Meaux
Journal of Vascular Surgery | Year: 2010

Descending thoracic aorta to femoral artery bypass is an effective and safe procedure for the treatment of aortoiliac occlusive disease when an approach to the abdominal aorta is undesirable. The major limitation of this technique has resulted from the morbidity rate associated with thoracotomy in a relatively high-risk vascular surgery population. As a minimally invasive procedure, videoendoscopy has been shown to improve the patient postoperative course and comfort in the field of general and thoracic surgery. The same benefits could be expected from a videoendoscopic surgery involving the thoracic aorta. In 2003 we reported the first case of a totally videoendoscopic descending thoracic aorta-to-femoral artery bypass procedure. In this article we report our additional experience with and the modifications we have made to this technique. © 2010 Society for Vascular Surgery. Source

Preudhomme C.,Lille University Hospital Center | Guilhot J.,French Institute of Health and Medical Research | Nicolini F.E.,Hematologie Clinique Hopital Edouard Herriot | Guerci-Bresler A.,Nancy University Hospital Center | And 19 more authors.
New England Journal of Medicine | Year: 2010

Background: Imatinib (400 mg daily) is considered the best initial therapy for patients with newly diagnosed chronic myeloid leukemia (CML) in the chronic phase. However, only a minority of patients treated with imatinib have a complete molecular remission. Methods: We randomly assigned 636 patients with untreated chronic-phase CML to receive imatinib alone at a dose of 400 mg daily, imatinib (400 mg daily) plus cytarabine (20 mg per square meter of body-surface area per day on days 15 through 28 of each 28-day cycle) or pegylated interferon (peginterferon) alfa-2a (90 μg weekly), or imatinib alone at a dose of 600 mg daily. Molecular and cytogenetic responses, time to treatment failure, overall and event-free survival, and adverse events were assessed. An analysis of molecular response at 12 months was planned. A superior molecular response was defined as a decrease in the ratio of transcripts of the tyrosine kinase gene BCR-ABL to transcripts of ABL of 0.01% or less, corresponding to a reduction of 4 log10 units or more from the baseline level, as assessed by means of a real-time quantitative polymerase-chain-reaction assay. Results: At 12 months, the rates of cytogenetic response were similar among the four groups. The rate of a superior molecular response was significantly higher among patients receiving imatinib and peginterferon alfa-2a (30%) than among patients receiving 400 mg of imatinib alone (14%) (P = 0.001). The rate was significantly higher among patients treated for more than 12 months than among those treated for 12 months or less. Gastrointestinal events were more frequent among patients receiving cytarabine, whereas rash and depression were more frequent among patients receiving peginterferon alfa-2a. Conclusions: As compared with other treatments, the addition of peginterferon alfa-2a to imatinib therapy resulted in significantly higher rates of molecular response in patients with chronic-phase CML. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT00219739.). Copyright © 2010 Massachusetts Medical Society. Source

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