Shortening identification times: comparative observational study of three early blood culture testing protocols.

Background: While early appropriate antibiotic therapy is a proven means of limiting the progression of infections, especially bacteremia, empirical antibiotic therapy in sepsis is ineffective up to 30%. The aim of this study was to compare early blood culture testing protocols in terms of their ability to shorten the delay between blood sampling and appropriate antibiotic therapy.

Methods: In this french observational study, we compared three blood culture testing protocols.

Femoral Arterial Thrombosis in a Young Adult after Nonsevere COVID-19.

Introduction: Few cases of arterial thromboembolisms have been reported after novel coronavirus disease 2019 (COVID-19) in case of severe infection or in elderly patients. We report a case of femoral arterial thrombosis in a young patient after nonsevere infection.

Case Description: A common femoral artery thrombosis extended in the first third of superficial and profunda femoral arteries associated with tibial posterior and popliteal artery thrombosis was diagnosed in a 24-year-old man complaining of right lower limb pain for one month.

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial).

Objective: The aim was to assess 18 month outcomes of the paclitaxel eluting balloon (PEB) in patients with femoropopliteal (FP) in-stent restenosis (ISR).

Methods: In a national prospective and multicentre cohort study, symptomatic patients with femoropopliteal in-stent restenosis were included from January 2012 to June 2013. Patients were treated by paclitaxel eluting balloon angioplasty (In Pact Admiral, Medtronic, Santa Rosa, CA, USA).

Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group.

Background: There are only scarce data about the benefit of adjunctive chemotherapy in patients with localized synovial sarcoma (SS).

Patients And Methods: Data from 237 SS patients recorded in the database of the French Sarcoma Group were retrospectively analyzed. The respective impact of radiotherapy, neo-adjuvant chemotherapy and adjuvant chemotherapy on overall survival (OS), local recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) were assessed after adjustment to prognostic factors.

[Standards, options and recommendations for the management of prostate cancer: therapeutic decision criteria].

Context: The "Standards, Options and Recommendations" (SOR) collaborative project was initiated in 1993 by the Federation of the French Cancer Centres (FNCLCC), with the 20 French Regional Cancer Centres, several French public university and general hospitals, as well as private clinics and medical specialty societies. Its main objective is the development of serviceable clinical practice guidelines in order to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review, followed by critical appraisal by a multidisciplinary group of experts.

Venous allografts preserved at 4 degrees C for infrainguinal bypass: long-term results from 170 procedures.

From April 21, 1982 to December 31, 1997, we performed 170 infrainguinal bypass procedures using isolated (n = 35) or composite (n = 135) venous allografts preserved at 4 degrees C as a substitute for saphenous autografts in 146 patients. The mean age of the patient population was 74 years. The indication was critical lower limb ischemia in 71% of cases.

Impact of cerebrospinal fluid PCR on the management of HIV-infected patients with varicella-zoster virus infection of the central nervous system.

Over a 2 year period, we identified five HIV-infected patients who presented with central nervous system infection caused by varicella-zoster virus, three with myelitits, and two with meningoencephalitis. All five patients were profoundly immunocompromised. Clinical presentation of these patients overlapped to a significant extent with diseases caused by other viruses, e.

Nine breast angiosarcomas after conservative treatment for breast carcinoma: a survey from French comprehensive Cancer Centers.

Objectives: To conduct a survey of the angiosarcomas developing after breast conservation for carcinoma in the French Cancer Centers, to study the evolution of these cases in detail, and to review literature in an attempt to propose an optimal treatment scheme.

Material And Methods: Eleven of the 20 French Cancer Centers agreed to research and retrospectively analyze all angiosarcomas discovered in patients previously treated by conservative treatment. The majority of the patients were node negative, T1N0M0.

Long-term results with a Palmaz stent in the femoropopliteal arteries.

Highly contradictory results are achieved with stents in the superficial femoral and popliteal arteries. In order to compare our experience, we have reviewed a series of patients in whom a Palmaz stent was implanted at the femoropopliteal level. From January, 1991, to December, 1994, 35 patients were treated for claudication (63%) or for critical ischemia (37%), using endoluminal angioplasty and the implantation of a Palmaz stent.

[-Emergency surgical treatment of acute carotid occlusion-].

Conservative medical treatment of acute occlusion of the extracranial internal carotid artery usually gives mediocre results. When a major neurological deficit is involved, mortality can reach 16 to 55%, morbidity due to definitive deficit 40 to 69% and cure only 2 to 12%. It is thus logical to attempt revascularization as an emergency procedure.

[Aneurysmal iliac lymphangiomyoma. Report of a case].

Single lymphangiomyoma, rarely encountered, is a form of lymphangiomyomatosis with characteristic proliferation of smooth muscle cells in lymph nodes and vessels. We observed a case in a 47-year-old woman with no past medical history. An echography performed for menorrhage revealed a single iliac localization in the right pelvis.

[Extra-abdominal desmoid tumors. Therapeutic indications. Apropos of 28 cases].

Between 1965 and 1989, 46 desmoid tumors were observed in the hospitals of Lyon. Twenty-eight patients with an extra-abdominal tumor, with a follow-up of at least 6 months were observed. In this group, there were 12 males and 16 females with an average of 26.

[Popliteal venous aneurysm and recurrent pulmonary embolism. A case report].

Primary popliteal vein aneurysms are rare, in contrast with veinous dilatation secondary to trauma or complicating an arterio-veinous fistula. The authors report the case of recurrent pulmonary embolism in a 46 year old man with a popliteal vein aneurysm. This veinous malformation usually presents with pulmonary embolism due to migration of blood clot from the thrombosed aneurysmal sack.

Mixed venous oxygen saturation in abdominal aortic surgery: intraoperative hypothermia and vasodilator therapy implications.

This prospective study was designed to test the hypothesis that intraoperative hypothermia occurring during abdominal aortic surgery and vasodilator therapy used to avoid severe consequences of aortic clamping could both disturb the mixed venous oxygen saturation signal (SVO2). Twenty high risk surgical patients, ASA physical status II or III, were catheterized with the standard pulmonary artery catheter; SVO2 was determined by direct spectrophotometric measurements of oxygen haemoglobin concentration of serial samples. The relationships between SVO2, haemodynamic, metabolic variables and core temperature were analyzed.

[Spontaneous and isolated dissection of the external iliac artery. Presentation of a case].

Primary dissecting aneurysms of peripheral arteries without involvement of the aorta are rare. The present report deals with a case of dissecting aneurysm of the external iliac artery in a 39-old man treated by resection and prosthetic graft. Although the exact cause of the dissection was not apparent, it seems likely that it was related to disorder of connective tissue because of the presence of a pectus excavatum, a deep palate and an increased hydroxyproline urinary excretion.

[Emergency vascular access in patients with renal failure. Apropos of 32 implantations of permcath].

Central venous catheters allow for the most rapid hemodialysis procedure with sparing of peripheral blood vessels. 32 flexible, double-lumen "permcath" catheters were implanted to 27 patients over a period spanning 42 months (February 86-August 89). Catheter placement was definitive in 2 cases while another 30 provided previsory intravenous access for plasmapheresis (25 cases), acute renal insufficiency (7 cases), and chronic renal failure (17 cases).

[Radiation-induced thrombosis of the carotid artery and lingual necrosis. Report of a case treated by cervical peridural nerve block].

A case of lingual necrosis in a patient irradiated 3 years earlier for a tonsillar tumor is presented. Imputability to a post-radiology bilateral external carotid thrombosis is evoked, where the diagnosis of tumoral recurrence and Horton's disease have been ruled out. Cervical peridural nerve block allowed successful treatment of this lesion.

[Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia with mitomycin C. Initial experience].

Intra-peritoneal chemo-hyperthermia with mitomycin C was used to treat 9 patients with very advanced gastrointestinal cancers with peritoneal seedings. Resection of the primary tumor was possible in 3 cases. After temporary of closure of the abdominal wall, 90 to 120 minutes of intra-peritoneal chemo-hyperthermia was performed under general anaesthesia with 32 degrees C of systemic hypothermia, via 3 intra-peritoneal drains forming a closed circuit, using 10 mg/l of mitomycin C in 61 of peritoneal dialysate warmed at the inflow temperature of 46 to 49 degrees C.

[Cancer of the testis, sarcoidosis and neurinoma].

The association of testicular cancer, sarcoidosis and neuroma is reported. Review of the literature revealed the rarity of the association of testicular cancer and sarcoidosis which is probably a chance association, but which is important in the context of staging, as overstaging may lead to useless or even dangerous treatment.

[Late results of Warren's distal splenorenal shunt].

To assess the long term results of the Warren distal splenorenal shunt, 53 patients suffering from chronic liver disease and managed with such a procedure from 1975 to 1981 for bleeding esophageal varices were evaluated. No rebleeding occurred after the immediate postoperative period. Five-year survival was 62 +/- 13 p.

[Exeresis of residual masses of germinal tumors of the testis after chemotherapy].

Between 1978 and 1988, amongst the 184 patients treated at the Hôpital du Val de Grâce for a testicular germ cell tumour, 47 patients underwent resection of residual masses after chemotherapy: 27 patients were classified as stage II and 20 were classified as stage III. The chemotherapy, administered for 3 to 6 cycles, used three types of protocols: VAB 6, PVeBV or BEP. Resection of residual masses was only undertaken after return to normal of the biological markers with persistently abnormal medical imaging.