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Sainte-Foy-lès-Lyon, France

Skowron F.,Center Hospitalier Of Valence | Bensaid B.,Drug Allergy Unit CCR2A | Balme B.,Center Hospitalier Lyon Sud | Depaepe L.,Center Hospitalier Lyon Sud | And 11 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Background Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and severe adverse drug reaction. Large detailed studies of histopathological features of DRESS are sparse and suggest an association between keratinocyte damage and the severity of visceral involvement. Objectives To describe the dermatopathological features in a large series of DRESS and their possible association with clinical features and the severity of the disease. Methods A retrospective analysis of the clinicobiological and dermatopathological features in a monocentric cohort of patients with DRESS. Results From January 2005 to January 2013, 45 patients were validated as probable or definite cases of DRESS. The median age was 64 years (range 3-87). The most frequent clinical and biological features included: fever ≥38.5C (95%), facial oedema (72%), enlarged lymph nodes (51%), visceral involvement (75%), blood eosinophilia (97%) and atypical lymphocytes (82%). Severe DRESS occurred in 24% and a fatal outcome in 6% of patients. Histopathological analysis showed that no specific histopathological pattern was characteristic for DRESS. However, several changes in different cutaneous compartments were observed in 2 of 3 of cases. Spongiosis (55%) and keratinocyte damage (53%) were the most common epidermal changes. Spongiosis was associated with non-severe DRESS (P = 0.041) whereas confluent keratinocyte necrosis correlated with severe DRESS (P = 0.011). Vascular changes were frequent (88%). A moderate dermal perivascular lymphocytic infiltrate was invariably present, containing eosinophils, neutrophils and/or atypical lymphocytes in 57% of cases. Conclusions Epidermal changes are indicative for the severity of DRESS. © 2015 European Academy of Dermatology and Venereology. Source


Lheureux-Portmann A.,Groupe Hospitalier Pitie Salpetriere | Lapalus-Curtoud Q.,Groupe Hospitalier Pitie Salpetriere | Tankere F.,Groupe Hospitalier Pitie Salpetriere | Disant F.,Groupement Hospitalier Edouard Herriot | And 2 more authors.
Revue de Laryngologie Otologie Rhinologie | Year: 2013

The facial palsy cause serious consequences for patients. Studies have also shown that in these patients, the inability to produce an appropriate and spontaneous smile would be a key factor of depression [1, 2]. When facial palsy is considered complete and the nerve cannot be repaired, the patient can benefit from palliative surgery to regain a better quality of life in the aesthetic, functional, and psychological aspects. The hypoglossal-facial anastomosis (AHF), temporal myoplasty (MAT) and gracilis transposition (TG) are the major surgeries currently used for this purpose. The aim of our study is to assess quantitatively and qualitatively the effects of each of these surgeries on the lip mobility and production of smile. From this perspective, we proposed a protocol of an evaluation of facial motricity, of quality of life, and more particularly on the quality and the analysis of the smile. The results underline that there is no significant difference in the recovery of the facial motricity according to the surgery. Only the slower, deferred deadline of recovery at the patients AHF and TG who have to wait several months, it is for the same levels as that of the patients' MAT. A premature and intensive rehabilitation such as the patients of our protocol benefited from it what is nevertheless essential to a good recovery whatever is the surgery. Source


Spring P.,University of Lausanne | Fellmann F.,University Hospitals Geneva Medical Center | Giraud S.,Groupement Hospitalier Edouard Herriot | Clayton H.,University of Lausanne | Hohl D.,University of Lausanne
American Journal of Dermatopathology | Year: 2013

Birt-Hogg-Dubé Syndrome (BHD) is a rare condition, transmitted as an autosomal-dominant trait. The etiology is due to a mutation in the BHD gene, which encodes folliculin (FLCN), located on chromosome 17p. The skin changes observed are benign skin tumors consisting of hamartomas of the hair follicle with dermal changes. Patients with BHD have an increased risk of spontaneous pneumothorax due to rupture of lung cysts and an increased risk of kidney tumors. We report 3 new cases of BHD and discuss their clinical features, histopathological findings, and molecular diagnostics. We highlight the importance of genetic analysis to confirm the diagnosis because of the clinical pitfalls involved in establishing a diagnosis. Finally, we discuss the histopathological features in BHD and tuberous sclerosis complex and focus on their overlapping criterias. A correct diagnosis is essential as it can be life saving for patients. Copyright © 2013 by Lippincott Williams & Wilkins. Source


Cassier P.,Ecole Normale Superieure de Lyon | Sautour M.,Center Hospitalier University | Gautheron N.,CNRS Agroecology Lab | Wegrzyn J.,Groupement Hospitalier Edouard Herriot | And 4 more authors.
Mycopathologia | Year: 2015

Recent literature has shown the growing importance of opportunistic fungal infections due to Fusarium spp. However, disseminated fusariosis remains rare in patients without neutropenia. We report a case of fungaemia in a 78-year-old French woman without definite immunodeficiency. Fusarium proliferatum grew from both central and peripheral blood cultures. Fever was the only clinical sign of the infection. An appropriate antifungal therapy with voriconazole led to the recovery of the patient. An environmental investigation was undertaken but failed to find a reservoir of Fusarium spores. A contaminated central venous catheter might have been the source of fungaemia. © 2014, Springer Science+Business Media Dordrecht. Source


Galy G.,Groupement Hospitalier Edouard Herriot | Bauler S.,Groupement Hospitalier Edouard Herriot | Pirot F.,Groupement Hospitalier Edouard Herriot | Pirot F.,Rockefeller University | Pivot C.,Groupement Hospitalier Edouard Herriot
Bulletin du Cancer | Year: 2011

The interest of centralization of preparations of chemotherapy drugs is in addition to its economic aspect, to secure drugs circuit. The aims of this study are to determine needs in employees and equipments of 11 theoretical levels of production from 1,000 to 50,000 preparations per year and to determine the cost of chemotherapy's preparation for each theoretical unit. The operating cost was divided in four areas of expenditure: employees (66-78%), investment (5-15%), maintenance (3-15%) and consumables (4-16%). If we consider the 11 units, the theoretical cost varies between 27.4 € for a unit with 50,000 preparations per year and 114.1 € for a unit with 1,000 preparations per year. This study shows the importance of setting up an optimal unit of preparations according to its activity and highlights the high cost's variation in relation to the activity of the unit. ©John Libbey Eurotext. Source

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