Saint-Jacques-de-la-Lande, France
Saint-Jacques-de-la-Lande, France

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Mathis S.,Hopitaux Universitaires Paris Center Cochin | Mathis S.,University of Paris Descartes | Chapuis N.,Hopitaux Universitaires Paris Center Cochin | Chapuis N.,University of Paris Descartes | And 16 more authors.
Leukemia | Year: 2013

Several groups have published flow cytometry scores useful for the diagnosis or prognosis of myelodysplastic syndromes (MDS), mainly based on the detection of immunophenotypic abnormalities in the maturation of granulocytic/monocytic and lymphoid lineages. As anemia is the most frequent symptom of early MDS, the aim of this study was to identify markers of dyserythropoiesis relevant for the diagnosis of MDS analyzed by selecting erythroblasts in a whole no-lysis bone marrow strategy by using a nuclear dye. This prospective study included 163 patients, including 126 with cytopenias leading to MDS suspicion and 46 controls without MDS. In a learning cohort of 53 unequivocal MDS with specific markers, there was a significant difference between the coefficients of variation of mean fluorescence intensities of CD71 and CD36 in MDS patients compared with controls. These two parameters and the hemoglobin level were used to build a RED-score strongly suggestive of MDS if ≥3. Using the RED-score in the whole cohort, 80% of MDS or non-MDS patients were correctly classified. When combined with the flow score described by Ogata et al., this strategy allowed to reach a very high sensitivity of 88% of patients correctly classified. © 2013 Macmillan Publishers Limited All rights reserved.

Alifano M.,Hopitaux universitaires Paris Center Cochin | Alifano M.,University of Paris Descartes
Revue des Maladies Respiratoires Actualites | Year: 2013

Pleural fistulas are characterized by a communication between the pleura and another structure. They can have various clinical forms and multiple locations. However, they have a common characteristic, namely pleural infection, and the occurrence of respiratory and nonspecific infectious symptoms. Among them, the bronchopleural fistula is the most frequent, and can occur in two circumstances:after pulmonary resection (mainly pneumonectomy), and in case ofpleuro-pulmonary infectious (particularly in the context of necrotizing pneumonia). Literature on pleural fistula consistis mainly of small series and cases reports, and no evidence based medicine guidelines are available. However, there are general principles of treatment, based on a multidisciplinary approach depending on the type of fistula (cause, topography) and patient status. Closed or open drainage (pleurostomy) of empyema is the mainstay of pleural fistulas treatment with, in a second time, a surgery to repair/resect lesions and possibly fill residual spacein case of open drainage. © 2013 Elsevier Masson SAS.

Crepy M.-N.,Hopitaux universitaires Paris Center Cochin
Revue Francaise d'Allergologie | Year: 2012

Recent literature about hand eczema is proposing new classifications of this disease, the most prevalent occupational skin disease. Among the most common allergens, nickel and rubber additives are described. Current strategy for preventing is also discussed, mainly protective gloves and alcohol-based hand rubs. © 2012 Elsevier Masson SAS.

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