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Clermont-Ferrand, France

Mick G.,Center Hospitalier Of Voiron | Guastella V.,CHU de Clermont Ferrand
Chronic Postsurgical Pain | Year: 2014

Primum non nocere The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela?. This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book. © 2014 Springer International Publishing Switzerland. All rights reserved.

Viala M.,Institute Gustave Roussy | Brosseau S.,CHU de Clermont Ferrand | Planchard D.,Caen University Hospital Center | Besse B.,University Paris - Sud | Soria J.-C.,Institute Gustave Roussy
Bulletin du Cancer | Year: 2015

The identification of the EML4-ALK rearrangement in 5% of NSCLC enhanced the development of 1st generation ALK inhibitors such as crizotinib. Two phase III trials demonstrated crizotinib efficacy in second line metastatic (PROFILE 1007) and more recently first line metastatic (PROFILE 1014) NSCLC in terms of progression-free survival and also objective response. However, within 12 to 16 months, patients will progress due to the emergence of acquired resistance mechanisms such as mutation (L1196M) or amplification of the ALK gene, as well as activation of alternative signaling pathways (EGFR, KRAS). Second generation ALK inhibitors have been developed such as ceritinib, alectinib, and AP26113. This review will present those new drugs, summarize the results of their ongoing trials, and discuss the best way to treat ALK+ NSCLC patients. © 2015 Société Francaise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.

Penard-Morand C.,French Institute of Health and Medical Research | Penard-Morand C.,University Pierre and Marie Curie | Penard-Morand C.,Agro ParisTech | Raherison C.,Center Francois Magendie | And 7 more authors.
European Respiratory Journal | Year: 2010

The aim of this study was to evaluate the impact of urban air pollution, assessed through reliable indicators of exposure, on asthma and allergies in schoolchildren. A validated dispersion model combining data on traffic conditions, topography, meteorology and background pollution was used to relate 3-yrs averaged concentrations of major urban pollutants at the sites of schools to skin prick tests, exercise-induced asthma and reported asthma and allergies in 6,683 children (9-11 yrs) attending 108 schools randomly selected in six French communities. For the 4,907 children who had resided at their current address for the past 3 yrs, asthma (exercise induced, past year and lifetime) was significantly positively associated with benzene, SO2, particles with a 50% cut-off aerodynamic diameter of 10 μm (PM10), nitrogen oxides (NOx) and CO. In the same children, eczema (lifetime and past year) was significantly positively associated with benzene, PM10, NO2, NOx and CO, lifetime allergic rhinitis with PM10 and sensitisation to pollens with benzene and PM10. Among the 2,213 children residing at their current address since birth, the associations persisted for lifetime asthma with benzene (adjusted OR per interquartile range (95% CI) 1.3 (1.0-1.9)) and PM10 (1.4 (1.0-2.0)), and for sensitisation to pollens with volatile organic compounds (1.3 (1.0-1.9)) and PM10 (1.2 (1.0-1.9)). Accurately modelled urban air pollution was associated with some measures of childhood asthma and allergies. Copyright©ERS 2010.

The parasympathetic nervous system is activated during rest or digestion. Its neurotransmitter is acetylcholine, and its main effects on the heart and lungs are bradycardia and bronchoconstriction. Acetylcholinesterase inhibitors are indirect stimulants of the parasympathetic tone which can play a role in myasthenia, the slowing down of bowel function, as well as constitute powerful toxins. Cholinergic antagonists can be used to treat sinus bradycardia, hypersalivation or bronchospasm. © 2014 Elsevier Masson SAS.

Bazin J.-E.,CHU de Clermont Ferrand
Oxymag | Year: 2015

Vasovagal attacks are very common and usually not serious. Another form of fainting or a serious cause must be ruled out. Caused by hypertonia of the parasympathetic system, such an attack leads to bradycardia and various unpleasant manifestations. Nonmedical treatment consists in laying the person down, reassuring them and raising their legs. If the condition persists or occurs during the perioperative period, it is treated by an intravenous injection of atropine. © 2014 Elsevier Masson SAS.

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