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Le Touquet – Paris-Plage, France

Renard J.-P.,Hopital du Val de Grace | Sellem E.,Center Ophtalmologique Kleber | Nordmann J.-P.,Hopital des Quinze Vingts | Baudouin C.,Hopital des Quinze Vingts | And 8 more authors.
Acta Ophthalmologica | Year: 2013

Purpose: To evaluate known and potential risk factors, including nutritional, lifestyle and environmental factors, differentiating patients with high-tension primary open-angle glaucoma (POAG) from control subjects with ocular hypertension (OHT). Methods: In 2006-2007, 111 French ophthalmologists prospectively enrolled 339 cases of POAG and 339 age-matched controls with OHT. After a clinical examination with assessment of ocular risk factors, the ophthalmologist filled, during face-to-face interview, a detailed questionnaire developed by nutritionists and epidemiologist on lifestyle and environmental risk factors, including socio-demographic variables, dietary habits related to omega-3 fatty acids intake, smoking and alcohol drinking and professional exposure to pesticides and other chemicals. Associations of POAG with risk factors were estimated using conditional logistic regression, with adjustment for age, gender and duration of disease. Results: In the final multivariate model, by comparison with OHT, POAG was significantly associated with more frequent use of pesticides during the professional life [OR = 2.65, 95% confidence interval (CI): 1.04-6.78, p = 0.04] and with low consumption of fatty fish (OR = 2.14, 95% CI: 1.10-4.17, p = 0.02) and walnuts (OR = 2.02, 95% CI: 1.18-3.47, p = 0.01). POAG was also associated with higher frequency of heavy smoking (40 pack-years or more, OR = 3.93, 95% CI: 1.12-13.80, p = 0.03) but not with moderate (20-40 pack-years) and light smoking (<20 pack-years). Conclusions: These exploratory observations suggest a protective effect of omega-3 fatty acids and a deleterious effect of heavy smoking and professional exposure to pesticides in POAG. This will need to be confirmed in future studies. © 2012 The Author. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation. Source


Sevestre M.-A.,Service de Medecine Vasculaire | Belizna C.,CHU de Rouen | Durant C.,Nantes University Hospital Center | Bosson J.-L.,Grenoble University Hospital Center | And 4 more authors.
Journal des Maladies Vasculaires | Year: 2014

Cancer is associated with venous thromboembolism in 20% of patients. In such patients, thrombosis is difficult to treat, associated with bleeding, recurrence, and death. Specific treatments for venous thromboembolism in cancer are recommended. Guidelines have been implemented in many countries and international guidelines have been recently developed. We evaluated the adhesion to national French guidelines via a survey of cancer patients treated for venous thromboembolism. Methods: A national cross-sectional observational study evaluated the adhesion to guidelines in hospitalized patients. Good clinical practice was defined as initial 10-day treatment with injectable molecules followed by long-term treatment with low molecular weight heparin for at least 3 months. Demographic data, cancer type, stage, treatment, risk factors and type of thrombosis, were recorded. Results: Five patients were included in 47 centers. Overall adhesion to guidelines was present in 59% (55-63%) of patients (295/500). During initial treatment, adhesion was high (487/496; 98%) but dropped (296/486; 62%) during the long-term maintenance. In patients with renal insufficiency, only a fourth of them received the adequate treatment. A majority of patients had metastatic disease (64%). Cancer sites were gastro-intestinal (25%), gynecologic (23%), pulmonary (21%), hematological (14%), urologic (10%), or other (8%). Lung and hematological malignancies were significantly associated with the highest and lowest rates of adhesion. Conclusion: Adhesion to national guidelines for treatment of venous thromboembolism in cancer is not optimal. Good compliance is observed during initial treatment, but drops after 10 days, underlying the need for further education to achieve a better implementation on a national level. © 2014 Elsevier Masson SAS. Source


Auxemery Y.,Service medical de psychologie clinique appliquee a laeronautique | Lahutte B.,Hopital du Val de Grace
Annales Medico-Psychologiques | Year: 2015

We present the learned lessons from clinical practice of French military psychiatrists in Afghanistan between 2009 and 2013. The main tasks of these psychiatrists were: medical and psychological debriefing closer to the wounded soldiers, outpatient activity marked by psychotraumatology and liaison psychiatry, forensic activities and technical advice to the command. The psychiatrist at the Medical Surgical Hospital supports the health care team as much as he is benefiting to supervision by a more experienced practitioner. On his return, the practitioner transmits his experience, which will give us the opportunity to discuss the "Afghan syndrome" and mental disorders resulting from a double "psychic and brain" trauma. We conclude on this clinic and practice in exceptional conditions. © 2015 Elsevier Masson SAS. Source


Ferrand F.R.,Hopital du Val de Grace | Ferrand F.R.,Institute Gustave Roussy | Moussaid Y.,Hopital du Val de Grace | Moussaid Y.,Institute National dOncologie | And 5 more authors.
Bulletin du Cancer | Year: 2014

Disseminated intravascular coagulation (DIC) is a complex abnormality of hemostasis with dramatic consequences and long described as associated with tumors. Yet the diagnosis and management of paraneoplastic DIC are poorly defined. The purpose of this paper is to review DIC associated with solid tumors, at the pathophysiological and therapeutic levels in particular. We also report data from a recent retrospective series of patients with DIC in the context of a solid tumor, to illustrate the epidemiological, clinical and prognostic. ©John Libbey Eurotext. Source


Ducray F.,Rockefeller University | Dutertre G.,Hopital du Val de Grace | Ricard D.,Hopital du Val de Grace | Gontier E.,Hopital du Val de Grace | And 2 more authors.
Bulletin du Cancer | Year: 2010

A better understanding of gliomas biology is now leading to a combined histo-molecular classification of these tumors. In anaplastic gliomas ongoing studies depend on 1p/19q codeletion status and in glioblastomas on MGMT methylation status. Advanced brain tumor imaging elicits a better identification of gliomas evolutive potential of. In lowgrade gliomas, the importance of maximal resection and the role of chemotherapy are being increasingly recognized. In anaplastic gliomas, phase III studies have clarified the respective roles of chemotherapy and radiotherapy. In glioblastomas concomitant chemoradiotherapy is the standard. Most targeted therapies, namely anti-EGFR therapies have failed to demonstrate efficacy but anti-angiogenics are promising. The aim of this review is to discuss the main advances in adults' gliomas biology, imaging and treatment. ©John Libbey Eurotext. Source

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