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Senet P.,Hospital Tenon | Bause R.,Hautmedizin | Jorgensen B.,Copenhagen University
International Wound Journal | Year: 2014

Biatain and Biatain-Ag are two identical wound dressings except the fact that Biatain-Ag releases silver. In the present multinational double-blinded randomised controlled trial the effect of the two dressings were compared for treatment of venous leg ulcers. A total of 181 patients were treated for 6 weeks with either Biatain or Biatain-Ag followed by 4 weeks treatment with Biatain. Biatain-Ag showed superior performance in relative wound area reduction after 6 weeks treatment and the estimated treatment difference increased after 10 weeks indicating that the effect of silver continues at least for 4 weeks after treatment. A subgroup of the patients differed significantly from the others with respect to parameters associated with a poor healing prognosis; patients were older, had significant history of venous thrombosis, larger ulcers with longer duration and more often recurrent. For this subgroup of patients Biatain-Ag showed significant (P < 0·05) better performance in terms of relative ulcer area reduction and healing rate. In conclusion, this study suggests the superior performance of Biatain-Ag compared with the non silver-releasing dressing Biatain in particular for patients having ulcers associated with a poor healing prognosis. © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.


PubMed | National Cancer Institute INCa, Hospital Charles Nicolle, Institute Bergonie, Nice University Hospital Center and 15 more.
Type: Journal Article | Journal: The Journal of molecular diagnostics : JMD | Year: 2016

Personalized medicine has gained increasing importance in clinical oncology, and several clinically important biomarkers are implemented in routine practice. In an effort to guarantee high quality of molecular testing in France, three subsequent external quality assessment rounds were organized at the initiative of the National Cancer Institute between 2012 and 2014. The schemes included clinically relevant biomarkers for metastatic colorectal (KRAS, NRAS, BRAF, PIK3CA, microsatellite instability) and non-small cell lung cancer (EGFR, KRAS, BRAF, PIK3CA, ERBB2), and they represent the first multigene/multicancer studies throughout Europe. In total, 56 laboratories coordinated by 28 regional molecular centers participated in the schemes. Laboratories received formalin-fixed, paraffin-embedded samples and were asked to use routine methods for molecular testing to predict patient response to targeted therapies. They were encouraged to return results within 14 calendar days after sample receipt. Both genotyping and reporting were evaluated separately. During the three external quality assessment rounds, mean genotype scores were all above the preset standard of 90% for all biomarkers. Participants were mainly challenged in case of rare insertions or deletions. Assessment of the written reports showed substantial progress between the external quality assessment schemes on multiple criteria. Several essential elements such as the clinical interpretation of test results and the reason for testing still require improvement by continued external quality assessment education.


Debiais-Delpech C.,University of Poitiers | Godet J.,University of Poitiers | Pedretti N.,Bioalternatives | Bernard F.-X.,Bioalternatives | And 5 more authors.
Urologic Oncology: Seminars and Original Investigations | Year: 2014

Objectives: Genome-wide association studies have identified variants at multiple loci associated with prostate cancer (PCa) risk. Some of these loci include candidate susceptibility genes, such as MSMB, HNF1β, and C-terminal-binding protein (CtBP2). Except for MSMB, the clinicopathological significance of these genes has not been investigated. We therefore aimed to analyze their expression in PCa tissues, in relation with tumor progression and aggressiveness. Methods and materials: Protein expression was evaluated by immunohistochemistry on tissue microarrays containing samples from normal prostate (NL, n = 91), high-grade prostatic intraepithelial neoplasia (PIN, n = 61), clinically localized PCa (CLC, n = 434), PCa metastases (M, n = 28), and castration-resistant PCa (CRC, n = 49). Moreover, mRNA expression for each marker was assessed by quantitative real-time polymerase chain reaction, on 53 frozen samples of NL, CLC, and CRC. Results: These genes were differentially expressed at the different stages of PCa natural history. MSMB expression decreased with disease development and progression. In contrast, nuclear HNF1β and CtBP2 staining significantly increased in the CRC and M groups when compared with CLC, together with the transcripts levels. In patients with CLC, HNF1β and CtBP2 nuclear expressions were strongly associated with cancer cell proliferation. After adjusting for the Gleason score and the pathological stage, none of the candidate genes was significantly predictive of recurrence after radical prostatectomy. In patients with CRC, CtBP2 nuclear staining was associated with shorter overall survival. Conclusions: The decrease of MSMB expression during tumor progression strongly supports its role as a tumor-suppressor gene. Although its functions remain to be clarified in PCa cells, HNF1β and CtBP2 are associated with cancer cell proliferation, tumor progression, and castration-resistant disease. © 2014 Elsevier Inc.


Bendifallah S.,Hospital Tenon | Genin A.S.,Center Hospitalier Intercommunal Creteil | Naoura I.,Hospital Bichat | Chabbert Buffet N.,Hospital Tenon | And 12 more authors.
American Journal of Obstetrics and Gynecology | Year: 2012

Objective: Our objective was to develop a nomogram based on pathological hysterectomy characteristics to provide a more individualized and accurate estimation of lymph node metastasis in endometrial cancer. Study Design: Data from the Surveillance, Epidemiology, and End Results database for 18,294 patients who underwent hysterectomy and lymphadenectomy were analyzed. A multivariate logistic regression analysis of selected prognostic features was performed, and a nomogram to predict lymph node metastasis was constructed. A cohort of 434 patients was used for the external validation. Results: The nomogram showed good discrimination with an area under the receiver operating characteristic curve of 0.80 (95% confidence interval, 0.79-0.81) in the training set and 0.79 (95% confidence interval, 0.78-0.80) in the validation set. The nomogram was well calibrated. Conclusion: We developed a nomogram based on 5 clinical and pathological characteristics to predict lymph node metastasis with a high concordance probability. © 2012 Mosby, Inc.


Bendifallah S.,Hospital Tenon | Koskas M.,Hospital Bichat Claude Bernard | Koskas M.,University Pierre and Marie Curie | Ballester M.,Hospital Tenon | And 5 more authors.
American Journal of Obstetrics and Gynecology | Year: 2012

OBJECTIVE: We sought to evaluate whether patients with endometrial cancer in the Surveillance, Epidemiology, and End Results database who underwent lymphadenectomy demonstrate improved survival. STUDY DESIGN: The study population comprised 50,969 patients. The 3-year cause-specific survival was tested by using propensity score matching (PSM) analysis. RESULTS: The PSM analysis generated a balanced, matched cohort in which baseline characteristics were not significantly different. The benefit of systematic lymphadenectomy appears to be significant for presumed stage I International Federation of Gynecology and Obstetrics grade 3 cancers and presumed stages II-III cancer. The omission of lymphadenectomy in stage I did not appear to show a deleterious survival consequence if the differentiation grade was moderate (grade 2) or well (grade 1). CONCLUSION: Using PSM analysis, our results show no evidence of benefit in terms of survival for systematic lymphadenectomy in women with stage I endometrial cancer, except for grade 3 cancers. © 2012 Mosby, Inc.


Hugon-Rodin J.,Hospital Saint Antoine | Chabbert-Buffet N.,Hospital Tenon | Chabbert-Buffet N.,University Pierre and Marie Curie | Bouchard P.,Hospital Saint Antoine | Bouchard P.,University Pierre and Marie Curie
Annals of the New York Academy of Sciences | Year: 2010

The two main contraceptive methods are the combined pill and the intrauterine device. In several countries, sterilization is a commonly used alternative. The current goals of contraception remain to achieve effective, accessible, reversible, and well-tolerated birth control for everyone. Despite progress, these goals have not been reached. To achieve these goals, it is mandatory to create new hormonal combinations and to discover new contraceptive targets. Recent innovations associate the development of new progestogens, selective progesterone receptor modulators, and the creation of new contraceptive combinations. Other innovations involve the use of natural estrogens but also optimizing existing treatment regimens and doses, as well as the development of new methods of emergency contraception. Finally, a major step will be to invent an efficient contraceptive that carries the lowest possible risk associated with methods protecting against sexually transmitted diseases. In the future, in relation to progress in the fields of genomics, proteomics, and immunology, new methods of contraception will be developed. These methods will be more targeted and will eventually be nonhormonal and independent of sexual activity. © 2010 New York Academy of Sciences.


Vieira T.,Hospital Tenon | Girard N.,University Pierre and Marie Curie | Ung M.,Hospital Louis Pradel | Monnet I.,University Paul Sabatier | And 8 more authors.
Journal of Thoracic Oncology | Year: 2013

Background: Sarcomatoid carcinomas (SCs) are rare tumors that may arise in the lung, accounting for 0.4% of non-small-cell lung cancers; the prognosis is poor. Only few retrospective small-size series have studied the efficacy of chemotherapy (CT) for metastatic SC. Methods: Multicenter study of patients with advanced or metastatic SC who received fiurst-line CT. Clinical characteristics at baseline, response to first-line CT (Response Evaluation Criteria in Solid Tumors version 1.1), progression-free survival (PFS), and overall survival (OS) were retrospectively collected. Results: Ninety-seven patients were included. Median age was 62 (54-72) years. The majority of patients were men (70%), white (84%), and smokers (84%). Overall, 73% of patients received first-line platinum-based CT. At first tumor evaluation, 69% of patients experienced progression, 31% had disease control, and 16.5% had partial response. Partial response was observed in 20% of patients receiving platinum-based CT, and in none of those receiving non-platinum-based CT (p = 0.018). Median PFS was 2.0 months (confidence interval [CI] 95%: 1.8-2.3). PFS was not statistically different between patients receiving or not receiving a platinum-based CT. Median OS was 6.3 months (CI 95%: 4.7-7.8). There was a trend toward better OS for patients treated with platinum-based CT (7.0 months [CI 95%: 4.9-9.0] versus 5.3 months [CI 95%: 2.8-7.6]; p = 0.096). In multivariate analysis, disease control at first evaluation (hazard ratio = 0.38 [CI 95%: 0.21-0.59]) and at platinum-based CT (hazard ratio = 0.92 [CI 95%: 0.85-0.99]) was associated with better OS. Conclusion: SC is associated with poor prognosis and high rate of resistance to conventional first-line CT. New therapeutic strategies are needed, based on better knowledge of the carcinogenesis of SC. Copyright © 2013 by the International Association for the Study of Lung Cancer.


McCammon K.,Eastern Virginia Medical School | Haab F.,Hospital Tenon
European Urology, Supplements | Year: 2011

The AdVance ® transobturator sling, an innovative sling developed to correct postprostatectomy stress urinary incontinence, acts by repositioning the urethral sphincter complex back into the pelvis. Optimal placement of the sling on the urethral bulb is ensured by following a recommended surgical technique. Postoperative pain resolves spontaneously or is easily controlled with analgesics. Patients must comply with postoperative care instructions, that is, no strenuous exercise in the immediate postoperative period to avoid sling slippage. It is also feasible to conduct implantation of an inflatable penile prosthesis in men with erectile dysfunction at the same time as the AdVance ® sling. The subsequent placement of an artificial urinary sphincter is not compromised in men who have previously received the AdVance ® sling. The AdVance ® transobturator sling for postprostatectomy stress urinary incontinence is an innovative nonobstructive sling. Optimal placement of the sling on the urethral bulb is ensured by following a recommended surgical technique. A low rate of postoperative pain is reported. © 2011.


Kluge R.,University of Leipzig | Kurch L.,University of Leipzig | Montravers F.,Hospital Tenon | Mauz-Korholz C.,Martin Luther University of Halle Wittenberg
Pediatric Radiology | Year: 2013

The aim of this review is to give an overview of FDG PET/CT applications in children and adolescents with lymphoma. Today, FDG PET is used for tailoring treatment intensity in children with Hodgkin lymphoma within the framework of international treatment optimisation protocols. In contrast, the role of this method in children with Non-Hodgkin lymphoma is not well defined. This paper overviews clinical appearance and metabolic behaviour of the most frequent lymphoma subtypes in childhood. The main focus of the review is to summarise knowledge about the role of FDG PET/CT for initial staging and early response assessment. © 2012 Springer-Verlag Berlin Heidelberg.


Muroni M.,Hospital Tenon | Rouet A.,Hospital Tenon | Brocheriou I.,Hospital Tenon | Houry S.,Hospital Tenon
Journal of Gastrointestinal Surgery | Year: 2015

Introduction: Abdominal tuberculosis is one of the most prevalent form of extra-pulmonary disease, and the diagnosis is difficult because of non-specific clinical features. Method: We presented a case of a Tunisian woman with cough, nausea, decreased appetite and pelvic-abdominal pain. CT scan showed peritoneal thickening, peritoneal tiny nodules and enlarged mesenteric lymph nodes ascitic fluid. Sputum analysis was negative. Abdominal paracentesis was performed, and no malignant cell was detected. The Ziehl staining revealed a negativity for acid-fast bacilli. Results: Diagnostic laparoscopy was performed. Biopsy specimens of peritoneum, liver, omentum and diaphragm showed omental epithelioid granulomas with a centrale caseous necrosis and Langhans giant cells. The patient received anti-tubercular treatment. Conclusions: In case of suspicion of tuberculosis, when bacteriologic and cytologic analysis is negative, laparoscopy with biopsies is helpful for correct diagnosis and appropriate management. © 2015, The Society for Surgery of the Alimentary Tract.

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