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Gontier E.,Hopital dInstruction des Armees | Beuzeboc P.,University Pierre and Marie Curie
Medecine Nucleaire

We report here the cases of three patients presenting with prostate cancer history and chronic hemopathies in whom 18F-FCH PET/CT showed diffuse bone marrow uptake. All three patients had rising PSA. Diffuse bone marrow uptake was attributed to bone marrow involvement, caused by hemopathy. In our knowledge, similar 18F-FCH bone marrow uptake has not yet been described in chronic hemopathies. This pattern should not be mistaken with any metastatic bone involvement. Furthermore, attention has to be paid to detect coexisting skeletal metastases, which could be missed among the diffuse bone marrow uptake. © 2015 Elsevier Masson SAS. Source

Lefort H.,Service Medical dUrgence | Mendibil A.,Service Medical dUrgence | Romanat P.E.,Hopital dInstruction des Armees | Tourtier J.-P.,Service Medical dUrgence
Annales Francaises de Medecine d'Urgence

Fascia iliaca block is a safe and reliable block that is quite useful in prehospital emergency situations. This loco-regional analgesia can be used in the field. The block is used for pain relief in diaphysal femoral fracture, but also in hip bone lesions. The contra-indications are numerous for outcomes trauma and must be observed. The patient must be clearly informed about the technical procedure. This procedure is easy to realize, requiring little equipment. It consists in an injection of a single shot of local anaesthetic into an anatomical compartment containing nerves: femoral, lateral femoral cutaneous and obturator nerve. Analgesia results directly from the action of the local anaesthetic on sensitive fibres, and indirectly due to muscle relaxation. As for any regional anaesthesia, basic conditions of security are required with the immediate availability of the necessary resources in case of adverse and immediate complications (malaise, systemic toxicity and allergy). We present the realization of fascia iliaca block in prehospital setting. © 2013 Société française de médecine d'urgence and Springer-Verlag France. Source

Descourt R.,Institut Universitaire de France | Vergnenegre A.,University of Limoges | Barlesi F.,Aix - Marseille University | Lena H.,University of Rennes 1 | And 10 more authors.
Journal of Thoracic Oncology

The aim of this multicenter phase II trial was to evaluate the combination of oral vinorelbine and cisplatin with radiotherapy (RT) after cisplatin-docetaxel induction chemotherapy (CT) in patients with locally advanced non-small cell lung cancer (NSCLC). Patients and Methods: Patients with previously untreated, inoperable, histologically or cytologically confirmed stage IIIA or IIIB NSCLC, with performance status ≤1 and weight loss ≤10% received two cycles of induction CT with cisplatin (75 mg/m2) and docetaxel (75 mg/m2) every 3 weeks. Patients with a tumor response or stabilization continued to receive cisplatin (80 mg/m2) and oral vinorelbine (40 mg/m2) on days 1 and 8 for two cycles, with concomitant thoracic RT (2 Gy/d, 5 d/wk, and total dose 66 Gy). Results: Fifty-six patients were enrolled. All patients (n = 38) who received CT-RT were assessable for the tumor response. There were no complete responses. In the intent-to-treat analysis, the response rates were 32.1% after induction CT and 41.1% after CT-RT. The median progression-free and overall survival times were 9.2 months (95% confidence interval: 7-14) and 20.8 months (95% confidence interval: 13.7-24.1), respectively. Adverse effects of RT-CT were grades 3 to 4 neutropenia (four patients) and grade 3 esophageal toxicity (one patient). No treatment-related deaths occurred. CONCLUSION:: The oral vinorelbine-cisplatin combination with concurrent RT is feasible and has a favorable risk-benefit ratio in stage IIIA/IIIB NSCLC. Copyright © 2011 by the International Association for the Study of Lung Cancer. Source

Dujardin G.,French Institute of Health and Medical Research | Commandeur D.,Hopital dInstruction des Armees | Le Jossic-Corcos C.,French Institute of Health and Medical Research | Ferec C.,French Institute of Health and Medical Research | Corcos L.,French Institute of Health and Medical Research
Journal of Cystic Fibrosis

Background: Cystic fibrosis is caused by mutations of the Cystic Fibrosis Transmembrane conductance Regulator gene (CFTR). Among the 1795 reported mutations, 221 (12.31%) are believed to affect pre-mRNA splicing. Nevertheless, not all splicing mutations have been demonstrated, by functional assays, to affect splicing in living cells. Methods: We have used a minigene-based approach, coupled to site-specific mutagenesis, to analyze the effects of presumptive pre-mRNA splicing mutations. Results: We show here that the intron 11 1811+1G>C and the intron 12 1898+3A>G mutations strongly affected CFTR pre-mRNA splicing. The encoded proteins are predicted to be defective, which would thus participate in the disease phenotype of carrier individuals. Conclusions: These results further validate the minigene strategy for the study of presumptive splice mutations, and report unanticipated defects in splicing. Such assays should improve the analysis of genotype-phenotype correlations. © 2011 European Cystic Fibrosis Society. Source

Sarkozy C.,University Paris Diderot | Sarkozy C.,University of Versailles | Gardin C.,University of Paris 13 | Gachard N.,University of Limoges | And 14 more authors.
American Journal of Hematology

To provide data for future drug evaluation, we analyzed the outcome of 393 patients aged 50 years or older (median, 64 years) with AML in first relapse after treatment in recent ALFA trials. Salvage options were retrospectively classified as follows: best supportive care (BSC), low-dose cytarabine (LDAC), gemtuzumab ozogamicin (GO), intensive chemotherapy (ICT), or ICT combined with GO. Second complete remission (CR2) rate was 31% and median post-relapse survival was 6.8 months (0, 17, 42.5, 53, and 80% and 3.2, 5.6, 8.9, 9, and 19.8 months in BSC, LDAC, GO, ICT, and ICT+GO subsets, respectively). Age, performance status, WBC, CR1 duration, and favorable AML karyotype, but not other cytogenetic or molecular features, influenced post-relapse outcome. Multivariate adjustment and propensity score matching showed that intensive salvage (ICT/ICT+GO/GO versus LDAC/BSC) was associated with longer post-relapse survival, at least in patients with CR1 duration ≥12 months (P=0.001 and 0.0005, respectively). Of interest, GO appeared to be as effective as standard ICT, and ICT+GO combination more effective than standard ICT. In conclusion, older patients with CR1 duration ≥12 months appeared to benefit from intensive salvage and results observed with GO-containing salvage suggest that GO combination studies should be actively pursued in this setting. © 2013 Wiley Periodicals, Inc. Source

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