Service dOncologie

Rabat, Morocco

Service dOncologie

Rabat, Morocco
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Fertani S.,Service Doncologie | Pugliesi-Rinaldi A.,Service Doncologie
Revue Medicale Suisse | Year: 2017

Nausea is a common symptom among patients affected by chronic diseases or undergoing various treatments. Because nausea can result from many origins, there is a large differential diagnosis to explore. Its pathophysiology relies on numerous neurotransmitters, on which 5 types of antiemetic antagonists are effective (NK-1 receptor antagonists, antiserotoninergic, antidopaminergic, antihistaminic and anticholinergic agents). Glucocorticoids and benzodiazepines are also used to treat some types of nausea. Choosing the appropriate antiemetic can improve quality of life and treatment compliance.


Sciotto F.,Service Doncologie | Py C.,Service Doncologie | Tsantoulis P.,Service Doncologie
Revue Medicale Suisse | Year: 2017

Improvements in diagnosis and treatments explain the notable increase in patients chronically affected or recovering from cancer. This is a fragile population, who is physically, psychologically and socially affected by the consequences of the disease and the associated treatments. In addition to detecting a possible relapse, oncologists and primary care physicians have to deal with a variety of issues like psychological distress, sexual dysfunction, cardiotoxicity, cognitive impairment, fatigue and, in some cases, a second primary cancer. This is a real challenge for modern medical oncology, with an important financial impact. A long-Term structured follow-up could improve the management of patients with a history of cancer and favour their physical recovery and psychosocial integration.


Vuilleumier A.,Service Doncologie | Labidi-Galy I.,Service Doncologie
Revue Medicale Suisse | Year: 2017

As the worldwide incidence of cancer continuously rises, one of the measures to reduce mortality is early diagnosis while the disease is still curable. Colonoscopy screening and PAP-smears are worthwhile examples illustrating the impact of early diagnosis on mortality. Ovarian cancer is the first cause of mortality by gynecological cancers in Switzerland (incidence of 600 new cases / year), mostly diagnosed at advanced stages with a poor prognosis. Could surveillance measures improve survival ? Three large-scale randomized control trials failed to show mortality reduction from ovarian cancer with the methods currently available. A better comprehension of pathogenesis can allow the development of new strategies of screening.


Belhadj Chaidi R.,Service de medecine interne | Thollot C.,Unite decho Doppler | Ferru A.,Service doncologie | Roblot P.,Service de medecine interne | Landron C.,Service de medecine interne
Journal des Maladies Vasculaires | Year: 2013

Objectives: To assess adherence to French guidelines for curative treatment of thromboembolism in cancer patients, and to identify factors limiting their implementation. Patients and methods: Retrospective analysis of the medical files of cancer patients diagnosed with deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in one site between January 1st, 2010 and June 30th, 2011. Central venous catheter thrombosis and superficial vein thrombosis were excluded. Results: The series included 145 patients, among whom 113 (78%) had solid tumors (at a metastatic stage in 68% of cases) and 33 (22%) had hematologic malignancies. Low molecular weight heparin (LMWH) was prescribed as long-term treatment (>. 10. days) for 83 patients (57.2%) and a vitamin K antagonist (VKA) for 33 patients (22.7%). Bleeding required treatment modifications or discontinuation in 11 (7.5%) and 10 (6.8%) patients respectively. After 6. months, LMWH, VKA and fondaparinux were prescribed for 28, 27 and six (19.3%, 18.6% et 4.1%) patients respectively. Mean duration of anticoagulation was 176.8. days. Treatment was not affected by a history of venous thromboembolism, the presence of pulmonary embolism or proximal deep vein thrombosis but it was significantly shorter in case of thrombosis limited to muscular veins (115.5 vs 182.3. days, P<. 0.05). Overall, guidelines were fully implemented in only 68 (46.9%) patients, with regards to the choice of pharmacological class and duration of treatment. Conclusion: Adherence to national guidelines is insufficient and actions must be taken to improve the management of venous thromboembolism in cancer patients. © 2013 Elsevier Masson SAS.


Varin R.,University Pierre and Marie Curie | Varin R.,Laboratoire MERCI | Mirshahi S.,Research and Development Stago | Mirshahi P.,University Pierre and Marie Curie | And 7 more authors.
Thrombosis Research | Year: 2013

Introduction Defective thrombolysis, a thrombotic risk factor, can be attributed to the formation of a compact clot poorly accessible to fibrinolytic enzymes. Venous thrombi, rich in red blood cells (RBCs), and arterial thrombi containing various amounts of RBCS, plasma and whole blood (WB) clot permeability and degradability were compared. The effect of rivaroxaban, a potent direct factor Xa inhibitor, was also evaluated. Materials and Methods Fibrin permeability was determined by flow measurement through the clot. Clot degradability was evaluated by the amount of D-dimer generated by clot perfusion with plasminogen and tissue plasminogen activator. Fibrin clot structure was assessed by confocal microscopy. Results WB clot permeability (KS) and degradability were 6.7- and 38-fold lower, respectively, compared with plasma clots. This is attributed to 1) occlusion of fibrin pores by RBCs and 2) a consistent increase in thrombin generation due to platelets and RBCs inducing formation of a tighter clot. Rivaroxaban added to plasma or WB before clotting, in reducing thrombin generation, led to the formation of a looser clot that is more degradable by fibrinolytic enzymes. Permeability and degradability of whole blood clots formed in the presence of rivaroxaban were very similar to those of plasma clots. Conclusion The resistance to fibrinolysis of WB clots was reduced considerably when clots were formed with rivaroxaban. These results may have implications for the development of antithrombotic agents. © 2012 Elsevier Ltd.


Ben Aissa A.,Service dOncologie | Mach N.,Service dOncologie
Revue Medicale Suisse | Year: 2012

Lung cancer is the leading cause of cancer death in the world, favored by smoking. Nonsmall cell lung cancer is a heterogeneous disease whose prevalence is increasing among women. Epidemiological, hormonal and pathological factors explain tumor differences between men and women. Women have more frequently adenocarcinomas, EGFR mutations and respond better to cancer treatments. In recent decades, many advances have been made, allowing us to move from histological to molecular characterization of lung tumors. Further analysis of gender disparities will help us to understand and improve the management of patients with NSCLC.


Ben Aissa A.,Service dOncologie | Mach N.,Service dOncologie
Revue Medicale Suisse | Year: 2012

HPV infection, a sexually transmissible disease, causes squamous cell carcinoma in a small fraction of infected individuals, years after exposure. Several cancers both in female and male, such as cervical cancer, anal carcinoma and up to 50% of oropharyngeal tumors are related to serotypes 16 and 18 of HPV. Several studies evaluating vaccination of young women before HPV exposure showed very good protection against cervical dysplasia and carcinoma in situ. Health authorities' guidelines now widely recommend vaccination of female between 11 and 14 years old. Results of recent trials also reveal good protective effect in men, raising the question of immunizing both young women and men. Important medical and socio-economic issues will need to be addressed before implementing such program.


Koessler T.,Service dOncologie | Roth A.,Service dOncologie | Cacheux W.,Service dOncologie
Revue Medicale Suisse | Year: 2014

Stomach cancers are diagnosed at an early stage in less than 10% of cases in Europe. They are superficial tumours, involving the mucosa and the submucosa only. Node involvement is the most important prognostic factor for these tumours. To determine the optimal therapeutic strategy, it is necessary to carry out a precise work-up involving an endoscopy, with chemical or virtual colorations and an echoendoscopy. Gastric surgery is the reference treatment. Nowadays, endoscopic tumour resection is a validated curative alternative. High quality medical expertise is needed for those tumours with a good prognosis, after evaluating risk for node involvement, and should be followed by Helicobacter pylori eradication and regular endoscopic surveillance.


Monet A.,Center dImagerie Fonctionnelle | Merino B.,Center dImagerie Fonctionnelle | Lupo R.,Service dOncologie
Clinical Nuclear Medicine | Year: 2010

A 67-year-old man underwent whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for lymphoma screening. The results demonstrated no evidence of lymphoma recurrence, but a focal increased uptake of F-18 FDG in the prostate. There was no history of urinary symptoms. A biopsy diagnosed a prostatic adenocarcinoma. Incidentally, focal intense FDG uptake in the prostate gland should always require further investigations to confirm the presence of prostate cancer. © 2010 by Lippincott Williams & Wilkins.


Ferrand F.-R.,Service doncologie | Pavic M.,Service de medecine interne et cancerologie
Revue de Medecine Interne | Year: 2014

The treatment of metastatic prostate cancer since the 1940s is based on the consideration of oncogenic addiction to its androgen receptor (AR). The significant improvement in survival outcomes over the past decade depends not only on the development of effective cytotoxic chemotherapy but also new molecules targeting the AR or decreasing testosterone levels, even in case of castration-resistant cancer. In this review, we summarize the structure and function of the RA, the mechanisms of androgen suppression, the concept of resistance to castration, historical targeted treatment on the AR and those recently marketed as abiraterone acetate and enzalutamide. © 2014 Société nationale française de médecine interne (SNFMI).

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