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Évry, France

Cornet E.,University of Caen Lower Normandy | Tomowiak C.,University of Poitiers | Tanguy-Schmidt A.,University of Angers | Dupuis J.,Lymphoid haemopathy unit | And 12 more authors.
British Journal of Haematology | Year: 2014

Summary: A large, multicentre, retrospective survey of patients with hairy cell leukaemia (HCL) was conducted in France to determine the frequency of second malignancies and to analyse the long-term effects of the established purine nucleoside analogues (PNAs), cladribine and pentostatin. The survey retrospectively reviewed the medical history of patients and their immediate family, clinical and biological presentation at the time of HCL diagnosis, treatment choice, response to treatment, time to relapse and cause of death. Data were collected for 487 patients with HCL. Of the patients included in the survey, 18% (88/487) had a familial history of cancers, 8% (41/487) presented with malignancies before HCL diagnosis and 10% (48/487) developed second malignancies after HCL was diagnosed. An excess incidence of second malignancies was observed, with a standardized incidence ratio (SIR) of 1·86 (95% confidence interval (CI): 1·34-2·51), with no significant difference between PNAs. For second haematological malignancies alone, the SIR was markedly increased at 5·32 (95% CI: 2·90-8·92). This study highlights the high frequency of cancers in HCL patients and their family members. The frequency of second malignancies is notably increased, particularly for haematological malignancies. The respective role of pentostatin and cladribine in the development of second malignancies is debatable. © 2014 John Wiley & Sons Ltd. Source

Rosefort A.,University Paris - Sud | Cordier A.-G.,University Paris - Sud | Kaddioui S.,Sud Francilien Hospital | Beaumont B.,Unit of Fetal Pathology | And 3 more authors.
Pediatric and Developmental Pathology | Year: 2013

Chorioangioma is the most common benign vascular placental tumor. It is often small and has no clinical significance. Large chorioangiomata are rarer and can lead to fetal or maternal complications. Chorioangiomatosis is even rarer and is defined as a focal or multifocal proliferation of placental capillaries permeating villous tissue. Placental mesenchymal dysplasia (PMD) is characterized by the overgrowth of placental mesenchymal tissue and can be associated with fetal or obstetrical complications. We report a case associated with preeclampsia and intrauterine growth restriction, in which both chorioangiomatosis and PMD were present. © 2013 Society for Pediatric Pathology. Source

Hochberg G.,Sud Francilien Hospital | Pucheu S.,European Georges Pompidou Hospital | Pucheu S.,University Pierre and Marie Curie | Kleinebreil L.,UNFM | And 2 more authors.
Diabetes and Metabolism | Year: 2012

Aim: In 2001, the international Diabetes Attitudes, Wishes and Needs (DAWN) programme was launched to evaluate the psychosocial impact of diabetes. In France, DAWN experts carried out an observational study to further understand the impact of diabetes on the psychological well-being of people with diabetes, using the French version of the WHO-5 questionnaire. Methods: The WHO-5, a unidimensional five-item questionnaire that measures positive psychological well-being, was completed by 2213 patients (1670 with diabetes). A total sum score was calculated, ranging on a scale from 0 to 25. A score less than 13 indicated impaired well-being and a score less than 8 reflected likely depression. Results: The mean total well-being score for the whole study population was 14.1 ± 5.5, and 14.3 ± 5.5 for patients with diabetes and 13.5 ± 5.4 for patients with other chronic diseases. The average score for patients with diabetes only (15.1 ± 5.2) was higher than those for the other subgroups (P= 0.005), whereas the average scores for those using insulin (14.8 ± 5.2) and women with diabetes (13.2 ± 5.6) were significantly lower compared with the whole diabetic group (15.6 ± 5.1 [P= 0.03] and 15 ± 5.2 [P< 0.001], respectively). Conclusion: The WHO-5 questionnaire showed satisfactory psychometric properties in a large sample of French diabetic patients. The scale is unidimensional and highlighted differences in well-being, which was lower in diabetic women, in patients with other chronic diseases and in those treated with insulin. © 2012. Source

Guerci B.,Nancy University Hospital Center | Monnier L.,Institut Universitaire de France | Petit C.,Sud Francilien Hospital | Valensi P.,Paris Nord University | And 5 more authors.
Diabetes and Metabolism | Year: 2012

Aim: To compare continuous glucose monitoring (CGM) profiles on vildagliptin versus sitagliptin in addition to metformin, in patients with inadequately controlled type 2 diabetes mellitus (HbA1c 6.5-8.0%). Methods: A multicenter, prospective, randomised, open-label study with blinded endpoint analysis. CGM data acquired over three days - firstly on metformin alone and then 8 weeks after the addition of either vildagliptin (n=14) or sitagliptin (n=16) -were blinded and analyzed centrally. Results: In comparable populations with a mean baseline HbA1c of 7.1%, 24-hour glucose variability - measured by mean amplitude of glucose excursions and standard deviation of mean glucose concentration - showed similar improvement on both drugs versus metformin alone. In contrast, a series of predefined parameters reflecting daily glycaemic control - mean 24-hour blood glucose concentration, and the times spent in the optimal glycaemic range (70-140 mg/dL) and above the hyperglycaemic thresholds of 140 and 180 mg/dL together with the corresponding AUC values - were significantly improved from baseline only in the vildagliptin arm. In addition, overall hyperglycaemia (AUC[24h] >100mg/dL) significantly dropped from baseline on vildagliptin [-37%] but not on sitagliptin [-9%], while postprandial hyperglycaemia (AUC[0-4h]×3) was significantly reduced on both, and basal hyperglycaemia (overall - postprandial hyperglycaemia was reduced only on vildagliptin [-41%; P=0.04]). Conclusions: The addition of a DPP-4 inhibitor significantly reduced glycaemic variability with no difference between the two drugs. However, vildagliptin induced better circadian glycaemic control than sitagliptin with a significant decrease on overall hyperglycemia, mainly driven by reduction on basal hyperglycaemia. © 2012 Elsevier Masson SAS. Source

Franc S.,Center Detudes Et Of Recherche Pour Lintensification Du Traitement Du Diabete Ceritd | Daoudi A.,Center Detudes Et Of Recherche Pour Lintensification Du Traitement Du Diabete Ceritd | Mounier S.,Center Detudes Et Of Recherche Pour Lintensification Du Traitement Du Diabete Ceritd | Boucherie B.,Center Detudes Et Of Recherche Pour Lintensification Du Traitement Du Diabete Ceritd | And 7 more authors.
Diabetes and Metabolism | Year: 2011

The Health Authorities have huge expectations of telemedicine (TM): improved patient access to healthcare, a solution to the shortage of doctors in the face of an exponentially expanding disease, and reduced healthcare costs with improved quality. There are a host of applications for TM in the area of diabetes. TM has been validated and has been widely used to screen for diabetic retinopathy, and a number of studies are currently underway for the follow-up of diabetic foot ulcers. However, the main indication of TM remains the follow-up and control of blood glucose. In this area, many studies have been conducted to improve glycaemic control. While most of these studies have failed to show any benefits vs. conventional care, a small number have demonstrated great efficacy of this approach with regard to glycaemia. Using these studies, we attempt to define the key qualities of a successful TM system. How can we extend the results of these experiments beyond the framework of clinical studies and integrate them in daily practice so as to improve diabetes management? This is the key challenge for TM, implementation of which will require reorganization of healthcare, given the evolution of medical demographics. This reorganization will involve healthcare providers specialized in diabetes that may intervene in assigning physicians for especially distressed patients. However, such reorganization will require medico-economic evaluation before it can be implemented on a larger scale. © 2011 Elsevier Masson SAS. Source

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