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Cherbourg-Octeville, France

Meftah B.,University of Mascara | Meftah B.,University of Caen Lower Normandy | Lezoray O.,University of Caen Lower Normandy | Lecluse M.,Center Hospitalier Public du Cotentin | Benyettou A.,Oran University of Science and Technology - Mohamed Boudiaf
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2010

Spiking Neuron Networks (SNNs) overcome the computational power of neural networks made of thresholds or sigmoidal units. Indeed, SNNs add a new dimension, the temporal axis, to the representation capacity and the processing abilities of neural networks. In this paper, we present how SNN can be applied with efficacy for cell microscopic image segmentation. Results obtained confirm the validity of the approach. The strategy is performed on cytological color images. Quantitative measures are used to evaluate the resulting segmentations. © 2010 Springer-Verlag Berlin Heidelberg. Source

Advances in diagnostic techniques and therapies has enabled there to be better care for cancer patients. As there is always the risk of relapse, the word recovery is not used, rather the term remission, which implies regular monitoring. Post-cancer, as with time after-treatment, is therefore a time spent in uncertainty. Under these circumstances, a return to what is called a normal life is not really selfevident. The person has to set new goals, (re-)establish their own place in society. There is a hint of ambivalence to this post-cancer period: relief but also apprehension, the feeling of abandonment, a fear of what the future holds. It is these difficulties, that follow on from therapeutic treatment, which give rise to a new state of vulnerability. Particular attention needs to be paid to those who are more fragile, as they were not feeling ill at the time of diagnosis, in cases where, fortuitously, cancer has been discovered early, in the absence of clinical signs at a regular screening, for example. Healthcare professionals often feel helpless when faced with the concerns of past patients, as is the case for their loved ones, who do not always understand the ill-feeling felt by those they have supported. It is the duty of the carers to anticipate this suffering and recognise it, in order to help alleviate it. Thinking about life post-cancer is a requirement that should be carefully considered throughout the whole care process. But how can you plan for this after time, especially as it cannot be guaranteed at the time the announcement of the illness is made? Over the last few years, particular attention has been paid, at the start of the disease, with how the diagnosis is delivered. Consideration should also be given to the end of treatments, with some support on leaving the disease behind and entry into remission. © 2013 Springer-Verlag France. Source

Potier J.,Center Hospitalier Public du Cotentin
Nephrologie et Therapeutique | Year: 2010

Removal of the middle molecules (MM) weight toxins, and particularly of beta-2-microglobuline (b2M) is made first by convection technique with membranes habitually used in hemodiafiltration online (HDFOL). AN69 was in standard hemodialysis (HD) the reference membrane for the removal of b2M mostly (60%) by adsorption. Its use with convective methods is generally restricted to low efficiency modalities with low substitution rates (Qs), either with continuous HF or HDF for acute renal failure, or with acetate free biofiltration (AFB) for chronic renal failure. So-called adsorptive membranes do not have, at the present time, a well-defined indication for high efficiency HDFOL, which necessitates substitution rates (Qs) higher than 15 litres per session. The objective of this study is to demonstrate the feasibility of such an association between polyethyleneimine (PEI) surface treated AN69 and HDFOL both in qualitative and quantitative terms. Five patients were dialysed, respectively, with Nephral 500ST (AN69, PEI, surface 2.15 m2, Hospal France) in HD (HDNEP), postdilution HDF (PostNEP), predilution HDF (PreNEP) and as a reference, with FX80 (Helixone, surface 1,8 m2, Fresenius) in PostD (PostFX). For the small molecules (SM), equilibrated Kt/V (Kt/VEq) and the phosphorus (Ph) reduction ratio (RR)Ph have been measured. Considering the predominating adsorption of b2M by AN69, the removal of MM - b2M and myoglobine (Myo) - was also assessed by their RR (RRb2M and RRMyo). Results are convincing in terms of behaviour in relation to convective techniques, the 2.15 m2 membrane used during 4 hour sessions accepting Qs up to 25 litres with PostD and up to 59 litres with PreD, without any alarm of transmembrane pressure (TMP) or any fiber coagulation incident, proving without any ambiguity the absence of deleterious membrane plugging and its compatibility with high efficiency HDFOL. The behaviour of AN69 in HDFOL in relation to SM does not differ from HDNEP or FXPost. For MM, results for b2M are significantly lower (P = 0.01) for PostNEP (RR = 71.4%) in comparison with PostFX (RR = 79.3%), but the behaviour of AN69 is above all particular for higher molecular weight substances since results are significantly reversed (P = 0.03) for Myo (PM = 17,800 Da) in favour of PostNEP (RR = 73.6%) compared to PostFX (RR = 65.7%). These results open up new horizons for HDFOL and encourage us to focus future studies on the consequences of an optimized removal, mainly by absorption, of high molecular weight toxins, such as factor D, C3a, C3b and cytokines (IL-1 and TNF). The expected beneficial consequences concern complications linked to inflammation and oxidative stress, which could account notably, beyond the mere quantitative removal of b2M, for the quasi disappearance of any clinical expression of dialysis-related amyloidosis. © 2009 Association Société de néphrologie. Source

Sassier M.,Center Francois Baclesse | Dugue A.E.,Center Francois Baclesse | Clarisse B.,Center Francois Baclesse | Lesueur P.,Center Francois Baclesse | And 17 more authors.
Lung Cancer | Year: 2015

Objectives: In advanced non-small cell lung cancer (NSCLC), maintenance therapy has emerged as a novel therapeutic reference for patients with non-progressive disease after platinum-based induction chemotherapy. However, the use of double maintenance (DM) with pemetrexed and bevacizumab is still being evaluated in terms of its clinical benefits and safety profile. The objective of this retrospective study was to describe the reasons for DM discontinuation in a real-world setting. Materials and methods: Patients with advanced non-squamous NSCLC were eligible if they had received at least 4 cycles of induction chemotherapy, followed by at least 1 cycle of DM. They were identified by using the oncology pharmacy database of 17 French centers. Results: Eighty-one patients who began a DM after induction chemotherapy were identified from September 2009 to April 2013. Among the 78 patients who had stopped DM at the time of the analysis, the main reasons for discontinuation were disease progression (42%), adverse events (33%), and personal preference (8%). The most frequent toxicity responsible for DM discontinuation was renal insufficiency (54%). Conclusion: For patients with advanced NSCLC eligible for DM therapy, a particular attention should be paid to potential renal failure. Kidney function should be monitored carefully before and during DM to detect and manage early this adverse event. © 2015 Elsevier Ireland Ltd. Source

Sauneuf B.,Center Hospitalier Public du Cotentin | Bouffard C.,University of Caen Lower Normandy | Cornet E.,University of Caen Lower Normandy | Daubin C.,University of Caen Lower Normandy | And 11 more authors.
Annals of Intensive Care | Year: 2016

Background: Elevation of the immature/total granulocyte (I/T-G) ratio has been reported after out-of-hospital cardiac arrest (OHCA). Our purpose here was to evaluate the prognostic significance of the I/T-G ratio and to investigate whether the I/T-G ratio improves neurological outcome prediction after OHCA. Methods: This single-center prospective cohort study included consecutive immunocompetent patients admitted to our intensive care unit over a 3-year period (2012–2014) after successfully resuscitated OHCA. The I/T-G ratio was determined in blood samples collected at admission. Results: We studied 204 patients (77 % male, median age, 58 [48–67] years), of whom 64 % had a suspected cardiac cause of OHCA, 62 % died in the unit, and 31.5 % survived with good cerebral function. Independent outcome predictors by multivariate analysis were age, first shockable rhythm, bystander-initiated resuscitation, and I/T-G ratio. Compared to the model computed without the I/T-G ratio, the model with the ratio performed significantly better [areas under the ROC curves (AUCs), 0.78 vs. 0.83, respectively; P = 0.04]. These items were used to develop the MyeloScore equation: ([0.47 × I/T-G ratio] + [0.023 × age in years]) − 1.26 if initial VF/VT − 1.1 if bystander-initiated CPR. The MyeloScore predicted neurological outcomes with similar accuracy to the previously reported OHCA score (0.83 and 0.85, respectively; P = 0.6). The ROC–AUC was 0.84, providing external validation of the MyeloScore. Conclusions: The I/T-G ratio independently predicts neurological outcome after OHCA and, when added to other known risk factors, improves neurological outcome prediction. The clinical performance of the MyeloScore requires evaluation in a prospective study. © 2016, The Author(s). Source

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