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Le Touquet – Paris-Plage, France

Giroux Leprieur E.,AP HP | Giroux Leprieur E.,University of Versailles | Fallet V.,Groupe hospitalier Paris Saint Joseph | Wislez M.,AP HP | Wislez M.,Paris-Sorbonne University
Bulletin du Cancer | Year: 2015

Around 4% of advanced non-small cell lung cancers (NSCLC) harbor a ALK rearrangement, with high sensitivity to ALK inhibitor as crizotinib. However, the vast majority of these tumors end with a tumor progression after several months of treatment with crizotinib. Ceritinib is a 2nd generation ALK inhibitor, which showed high efficiency in NSCLC with ALK rearrangement. Results from phase I trial showed a response rate at 58% in these tumors, with a similar rate for previously crizotinib-treated patients or crizotinib-naïve patients. Moreover, cerebral responses were observed with ceritinib. Preliminary date from a phase 2 trial confirmed these results. These promising results allowed a European marketing authorization (autorisation de mise sur le marché [AMM]) since May 2015 for the treatment of advanced NSCLC with ALK rearrangement and resistance or intolerance to crizotinib. © 2015 Société Française du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés.

Rajzbaum G.,Groupe hospitalier Paris Saint Joseph | Grados F.,Center Hospitalier University | Evans D.,Lilly France | Liu-Leage S.,Lilly France | And 2 more authors.
Joint Bone Spine | Year: 2014

Objectives: The European Forsteo Observational Study assessed the clinical fracture incidence, back pain, quality of life (QoL), and treatment persistence amongst post-menopausal women, who were prescribed teriparatide in routine care in eight European countries. We present the results for France, with health-insurance reimbursement criteria channel teriparatide to women with severe disease and limit treatment to 18. months. Methods: A representative sample of women initiating teriparatide in France was followed in routine care for 36. months. We described patients' characteristics at baseline and persistence to teriparatide (Kaplan-Meier analysis), fracture incidence, back pain, and QoL (EQ-5D) at baseline, 18 and 36. months follow-up (last-observation-carried-forward (LOCF) and mixed-models-for-repeated-measures (MMRM). Results: One hundred and sixteen rheumatologists included 309 patients, of whom 290 (93.9%) had at least one follow-up visit. Women's mean age (standard deviation) was 74.5. years (7.4) and 296 (95.8%) had greater or equal to two vertebral fractures prior to teriparatide initiation. Clinical fracture incidence, mainly vertebral fractures, decreased around 6. months after teriparatide initiation, and was sustained at 36. months (P=0.013) when most patients were treated by anti-resorptives. Back pain and EQ-5D measures improved significantly at 18 and 36. months (P<. 0.0001) in the LOCF analyses but did not improve in the EQ-5D VAS measure after covariate adjustment in the MMRM model. Median treatment duration was 17.4. months. Conclusion: French women initiating teriparatide in routine care had severe osteoporosis and showed good treatment persistence, consistent with France's insurance reimbursement criteria. Improvements in fracture risk and back pain began soon after treatment and was maintained at 36. months follow-up. © 2013 Société française de rhumatologie.

Bouhemad B.,Groupe hospitalier Paris Saint Joseph | Monsel A.,University Pierre and Marie Curie | Brisson H.,University Pierre and Marie Curie | Arbelot C.,University Pierre and Marie Curie | Lu Q.,University Pierre and Marie Curie
Anesthesiology | Year: 2012

The aim of this review is to perform a critical analysis of experimental studies on aerosolized antibiotics and draw lessons for clinical use in patients with ventilator-associated pneumonia. Ultrasonic or vibrating plate nebulizers should be preferred to jet nebulizers. During the nebulization period, specific ventilator settings aimed at decreasing flow turbulence should be used, and discoordination with the ventilator should be avoided. The appropriate dose of aerosolized antibiotic can be determined as the intravenous dose plus extrapulmonary deposition. If these conditions are strictly respected, then high lung tissue deposition associated with rapid and efficient bacterial killing can be expected. For aerosolized aminoglycosides and cephalosporins, a decrease in systemic exposure leading to reduced toxicity is not proven by experimental studies. Aerosolized colistin, however, does not easily cross the alveolar-capillary membrane even in the presence of severe lung infection, and high doses can be delivered by nebulization without significant systemic exposure. © 2012, the American Society of Anesthesiologists, Inc.

Boulet L.-P.,Laval University | Vervloet D.,Aix - Marseille University | Magar Y.,Groupe hospitalier Paris Saint Joseph | Foster J.M.,University of New South Wales
Clinics in Chest Medicine | Year: 2012

Asthma management requires adequate adherence to many recommendations, including therapy, monitoring of asthma control, avoidance of environmental triggers, and attending follow-up appointments. Poor adherence is common in patients with asthma and is often associated with increased health care use, morbidity, and mortality. Many determinants of poor adherence have been identified and should be addressed, but there is no clear profile of the nonadherent patient. Interventions to improve adherence therefore demand tailoring to the individual by including patient-specific education, addressing patient fears and misconceptions, monitoring adherence, and developing a shared decision process. © 2012.

Moubarak G.,Groupe hospitalier Paris Saint Joseph | Anselme F.,Service de cardiologie
Reanimation | Year: 2015

Cardiac arrhythmias can be primitive or associated with a variety of cardiovascular conditions. Arrhythmias may be responsible for an important alteration of quality of life, syncope, heart failure, thromboembolic events, or sudden death. Their treatment includes antiarrhythmic medications and/or ablation. The choice is influenced by the type of arrhythmia, medical history, benefits and risks of each strategy in an individual patient, and patient preference. Ablation is the destruction of the cardiac structure responsible for the arrhythmia by using a source of energy which is usually radiofrequency and in some cases cryotherapy. We review the indications of ablation techniques in the treatment of atrial fibrillation, atrial flutter, atrioventricular nodal reentry, Wolff-Parkinson-White syndrome, and ventricular tachycardia. © 2015, Société de réanimation de langue française (SRLF) and Springer-Verlag France.

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