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Ziol M.,Service dAnatomie Pathologique | Ziol M.,University of Paris 13 | Sutton A.,Laboratoire Of Biochimie | Sutton A.,University of Paris 13 | And 18 more authors.
Journal of Hepatology | Year: 2013

Background & Aims The prognosis of hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA) is mainly linked to tumor recurrence. So far, no tissue biomarker of recurrence has been validated in biopsy samples. We aimed at investigating the prognostic value of tissue biomarkers in HCC biopsy samples of patients treated with RFA. Methods All consecutive naive patients from 3 university hospitals, with compensated cirrhosis, early-stage (BCLC 0/A) uninodular HCC treated with RFA, and available tumor biopsy, were included. Edmondson's grade, and the expression of cytokeratin 19, glutamine synthase, beta-catenin, epithelial cell adhesion molecule (EpCAM), and endothelial cell-specific molecule 1 (ESM-1) were assessed. Main clinical end points were overall and early recurrence. Statistical analyses were performed using Kaplan Meier, Log-rank test, and Cox models. Results 150 patients were included. Recurrence, death or liver transplantation occurred in 85, 51, and 12 patients, respectively. Median follow-up was 27 months. ESM-1 expression by HCC stromal endothelial cells was observed in 58 patients (40%) and was associated with higher serum AFP levels, larger tumor, and more frequent expression of EpCAM and surrogate markers of activation of the Wnt-ß-catenin pathway. The 2 independent predictive factors of overall recurrence were serum AFP (HR 1.11 [1.002; 1.22], p = 0.045) and ESM-1 expression (HR 1.56 [1.004; 2.43], p = 0.048). ESM-1 expression was also an independent predictive factor of early recurrence (HR 1.81 [1.02; 3.21], p = 0.042). Conclusions ESM-1 expression by stromal endothelial cells, in tumor biopsy samples, has an independent predictive value of early recurrence after RFA. © 2013 European Association for the Study of the Liver. Published. Source

Soria A.,University of Paris Pantheon Sorbonne | Soria A.,French Institute of Health and Medical Research | Barbaud A.,University of Lorraine | Assier H.,Groupe Hospitalier Henri Mondor | And 6 more authors.
Dermatology | Year: 2015

Background: Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. Objective: The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. Methods: All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. Results: We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. Conclusion: We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses. © 2015 S. Karger AG, Basel. Copyright: All rights reserved. Source

Krypciak S.,University Paris Est Creteil | Liuu E.,University Paris Est Creteil | Vincenot M.,University Paris Est Creteil | Landelle C.,Unite de Controle | And 7 more authors.
Revue de Medecine Interne | Year: 2015

Purpose: To study pneumococcal immunization coverage in older patients in hospital, and the impact of two actions aiming at improving this coverage. Methods: We reported a prospective and descriptive study conducted from November2009 to August2010, including all new patients ≥. 75years old received in a geriatric short-stay department and residing in Val-de-Marne, France. This study was performed in three successive three-month periods, to assess the vaccination coverage in the months following hospital release. PeriodI was the reference; PeriodII included an awareness campaign of general practitioners relying on the hospitalization discharge report, containing an indication for the vaccination; PeriodIII consisted in a systematic proposal of vaccination by the geriatric hospital department. Results: Indication for pneumococcal vaccination has been given to 139patients (61.2%) in 227 processed questionnaires. The main indication was heart failure for 105patients (75.5%). Twenty-four patients were already vaccinated (17.2%). No vaccination was reported in the three months following periodI in 33 included patients. The awareness campaign targeting regular doctors resulted in only one vaccination out of 37patients. Immunization coverage in the department had reached 84.5% of inoculation (38 of 45patients). Conclusion: Pneumococcal vaccination is often prescribed in elderly patients but generally not executed. The awareness campaign did not result in a big enough immunization coverage improvement, compared to a codified proposal of vaccination during hospital stay. © 2014 Société nationale française de médecine interne (SNFMI). Source

Schurhoff F.,Groupe Hospitalier Henri Mondor | Schurhoff F.,French Institute of Health and Medical Research | Schurhoff F.,University Paris Est Creteil
Annales Medico-Psychologiques | Year: 2011

The use of symptom dimensions of schizophrenia (positive, negative and disorganised) as quantitative phenotypes has been proposed as a mean to reduce the heterogeneity of schizophrenia and facilitate genetic research. The aim of the present study was to summarize the results of studies investigating the genetic background of the positive dimension. Several studies suggest a genetic contribution to the reality distortion dimension, but at a lesser degree than for the disorganised dimension. Few studies have investigated relationships between genetic factors and reality distortion dimension. However, some works suggest that genetic variation in DISC1 and COMT may be associated with delusions and hallucinations. As specific cognitive deficits have been suggested as explanations for the positive dimension, new strategies should focused on their correlations with genetic factors. For example, source-monitoring deficits (a presumed cognitive marker for increased proneness to psychotic symptoms) can be observed in subjects with 22q11 deletion syndrome, a region containing candidate genes such as Catechol-O-Methyltransferase (COMT) gene. © 2011 Elsevier Masson SAS. Source

Thiriez C.,AP HP | Gurruchaga J.-M.,Groupe Hospitalier Henri Mondor | Goujon C.,Groupe Hospitalier Henri Mondor | Fenelon G.,AP HP | And 2 more authors.
Neurotherapeutics | Year: 2014

Epidural spinal cord stimulation (SCS) is currently proposed to treat intractable neuropathic pain. Since the 1970s, isolated cases and small cohorts of patients suffering from dystonia, tremor, painful leg and moving toes (PLMT), or Parkinson's disease were also treated with SCS in the context of exploratory clinical studies. Despite the safety profile of SCS observed in these various types of movement disorders, the degree of improvement of abnormal movements following SCS has been heterogeneous among patients and across centers in open-label trials, stressing the need for larger, randomized, double-blind studies. This article provides a comprehensive review of both experimental and clinical studies of SCS application in movement disorders. © 2014 The American Society for Experimental NeuroTherapeutics, Inc. Source

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