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Le Touquet – Paris-Plage, France

Turrini O.,Institute Paoli Calmettes | Paye F.,University Paris 06 | Sauvanet A.,AP HP Hopital Beaujon | Sa Cunha A.,Maison du Haut Leveque | And 4 more authors.
European Journal of Surgical Oncology | Year: 2013

Aim: To determine the benefit of surgery for resectable pancreatic adenocarcinomas (PAs) in elderly patients. Methods: From 2004 to 2009, 932 patients with resectable PAs underwent pancreatectomies without neoadjuvant treatment in 37 institutions. The patients were divided into three groups according to age: <70 years (control group; n = 580); 70-79 years (70s group, n = 288), and ≥80 years (80s group; n = 64). Preoperative, intraoperative, postoperative, and histological data were recorded to assess the postoperative course and survival. Results: Preoperative or intraoperative characteristics, and the histological findings were comparable in the three groups. Postoperative mortality and morbidity rates did not differ in the three groups. Adjuvant therapies were more frequently used in younger patients than in elderly patients (p < 0.01). The overall 1-year, 3-year, and 5-year survival rates of control group/70's group/80's group were 82.2%/75.7%/75.7%, 49.9%/41.8%/31%, and 38.7%/33.2%/0%, respectively (p = 0.16). The median survival of the control, 70s, and 80s groups was 24 months, 35.3 months, and 30 months, respectively. Four independent prognostic indicators were identified by multivariate analysis: venous invasion (hazard ratio (HR) = 2.12), arterial invasion (HR = 2.96), positive lymph nodes (HR = 2.25), and adjuvant treatment (HR = 0.65). Conclusions: Fit elderly patients with resectable PAs should not be excluded from surgical resection of PA solely because of their real age. Moreover, elderly patients seem to obtain similar advantages from pancreatectomies than younger patients. © 2012 Elsevier Ltd. All rights reserved. Source


Ismaili Alaoui N.,University Sidi Mohammed Ben Abdellah | Hindie E.,Bordeaux University Hospital Center | Sergent Alaoui A.,Service de Medecine Nucleaire | Fakir S.,University Sidi Mohammed Ben Abdellah | And 3 more authors.
Medecine Nucleaire | Year: 2012

Introduction: Incidence of congenital hypothyroidism (CH) is about one in 3000 newborn and CH is the main cause of avoidable mental retardation and abnormality of growth. It may be permanent or transient. Thyroid scintigraphy allows in most of cases to specify the type of CH. The aim of this study was to clarify the contribution of scintigraphy for the diagnosis, management and prognosis of the children with CH, on basis the experience from the Nuclear Medicine department of Armand-Trousseau Children Hospital. Patients and methods: We retrospectively reviewed all the children (0-3months) referred between January 2005 and December 2008 to the pediatric hospitals in Paris for the management of neonatal hypothyroidism. A planar scintigraphic acquisition, including stomach and bladder, was done 1h after intravenous injection of 1.1MBq of 123I. When the thyroid was normally located, a perchlorate discharge test was performed. Results: During the study period, 181 infants had thyroid scintigraphy for CH. The sex-ratio girl/boy was 1.7. Fifty-six percent had thyroid dysgenesis (21% agenesis, 35% ectopia). Seventy-nine patients (44%) had an eutopic thyroid. A significant association was observed between TSH levels and etiology of HC, and between TSH levels and the percentage of iodine uptake decrease after the perchlorate discharge test: the highest level of TSH was observed in the case of athyreosis and when perchlorate test was very disturbed (fall of thyroid activity greater than 70%). Conclusion: Thyroid scintigraphy in association with ultrasound permits a precise characterization of the etiology of CH. These examinations help clinicians to ensure an optimal management of patients by identifying those with most severe hypothyroidism, and to inform parents most completely on duration of treatment and existence of a potential risk during a future pregnancy. © 2012 Elsevier Masson SAS. Source


Burguet A.,Service de Pediatrie 2 | Burguet A.,French Institute of Health and Medical Research | Burguet A.,University Paris 06 | Menget A.,Besancon University Hospital Center | And 4 more authors.
Archives de Pediatrie | Year: 2014

Objective: To compare the amount of medical interventions on very preterm neonates (24-31 weeks of gestation) in two French university tertiary care centers, one of which is involved in a Neonatal Developmental Care program. A secondary objective is to assess whether this difference in medical interventions can be linked to a difference in mortality and morbidity rates. Methods: We prospectively included all very preterm neonates free from lethal malformation born live in these two centers between 2006 and 2010. These inclusion criteria were met by 1286 patients, for whom we compared the rate of five selected medical interventions: birth by caesarean section, chest intubation in the delivery room, surfactant therapy, pharmacological treatment of patent ductus arteriosus, and red blood cell transfusion. Results: The rates of the five medical interventions were systematically lower in the center that is involved in Neonatal Developmental Care. There was no significant difference in survival at discharge with no severe cerebral ultrasound scan abnormalities between the two centers. There were, however, significantly higher rates of bronchopulmonary dysplasia and nosocomial sepsis and longer hospital stays when the patients were not involved in a Neonatal Developmental Care program. Discussion: This benchmarking study shows that in France, in the first decade of the 21st century, there are as many ways to handle very preterm neonates as there are centers in which they are born. This brings to light the concept of medical stance, which is the general care approach prior to the treatment itself. This medical stance creates the overall framework for the staff's decision-making regarding neonate care. The different parameters structuring medical stance are discussed. Moreover, this study raises the problematic issue of the aftermath of benchmarking studies when the conclusion is an increase of morbidity in cases where procedure leads to more interventions. © 2013 Elsevier Masson SAS. Source


Pinto Y.,Telecom ParisTech | Sarrazin J.,University Paris 06 | Lepage A.C.,Telecom ParisTech | Begaud X.,Telecom ParisTech | Capet N.,French National Center for Space Studies
Applied Physics A: Materials Science and Processing | Year: 2014

This paper presents the design, realization and measurement of a thin lightweight absorbing material for space applications. Absorber design is based on high impedance surfaces loaded with resistors and known as a resistive high impedance surface (RHIS). The behavior of RHIS is analyzed at normal and oblique incidences for TE and TM polarizations. Prototypes have been realized and measured. Final design has a reflection coefficient less than - 15 dB in S-Band (2-2.3 GHz) at normal incidence and till an angular dispersion of 40° for waves in TE polarization, and 35 ° for waves in TM polarization. Simulation results are validated by measurement. © 2013 Springer-Verlag Berlin Heidelberg. Source


Hilton F.,UK Met Office | Armante R.,French National Center for Scientific Research | August T.,EUMETSAT | Barnet C.,National Oceanic and Atmospheric Administration | And 39 more authors.
Bulletin of the American Meteorological Society | Year: 2012

The first Infrared Atmospheric Sounding Interferometer (IASI) was launched in October 2006 on the European Organization for the Exploitation of Meteorological Satellites' (EUMETSAT) Meteorological Operation (MetOp)-A satellite. The instrument and its successors will continue to operate until 2020 on the current MetOp platform and two follow-on satellites. The stability of the instrument is monitored routinely by the CNES Technical Expertise Center, using onboard measurements, and by EUMETSAT, where stable, clear fields of view are compared with simulated radiances from numerical weather prediction model output. Routine monitoring of IASI data and calibration and validation activities by CNES and EUMETSAT ensure full characterization of the instrument and verify that the performance meets the requirements. In-depth evaluation is routinely performed by comparing IASI with other instruments, such as AVHRR and the High Resolution Infrared Radiation Sounder (HIRS) on the MetOp platform. Source

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