Validation of a breast cancer nomogram for predicting nonsentinel node metastases after minimal sentinel node involvement: validation of the Helsinki breast nomogram.

Background: Complete node dissection for tumor-positive sentinel lymph nodes (SLN) is becoming more controversial. Nevertheless, current practice guidelines still recommend complete axillary lymph node dissection (ALND) for breast cancer patients whose SLN contains a metastatic tumor. The Helsinki breast cancer nomogram developed by Meretoja TJ et al.

[Influence of the instillation of two versus three eyedrops of cyclopentolate 0.5% on refraction of Caucasian nonstrabismic children].

Introduction: Children's refraction can usually be measured using cyclopentolate 0.5%. Instilling three drops is time-consuming and inconvenient to both the clinical staff and the child.

[How long can we wait at full dilatation. A study of maternal and neonatal morbidity related to the duration of the second stage of labour in nulliparous women].

Objectives: To determine the statistical association, in nulliparous patients, between maternal and fetal morbidity and the length of the second stage of labour. To precise whether a prolongation of this period of more than 2h may results in a dramatic increase of this morbidity.

Materials And Methods: Retrospective cohort study conducted in a level III referral centre between 1 April 2004 and 30 April 2005, including all nulliparous, term, cephalic, live singleton birth without fetal malformation in patients reaching the second stage of labour (n=1191).

[Treatment of Hailey-Hailey disease with carbon dioxide laser vaporization].

Introduction: Only ablative methods lead to long term remission of areas affected by Hailey-Hailey disease: excision/skin graft, cryosurgery, dermabrasion...

Occupational exposure in ANCA-positive patients: a case-control study.

Background: Antineutrophil cytoplasmic autoantibodies (ANCA) are valuable biomarkers for the diagnosis and follow-up of small vessel vasculitis. The role of ANCA has not yet been fully established, but genetic, infectious, and/or environmental factors may increase susceptibility to these diseases. We performed an epidemiologic study to investigate whether the presence of ANCA was associated with silica or any other form of occupational exposure, regardless of the underlying disease.

Medico-economic approach to the management of uterine myomas: a 6-month cost-effectiveness study of pelvic embolization versus vaginal hysterectomy.

Introduction: Uterine artery embolization is a technique that has been recently proposed for the management of uterine myomas an alternative to vaginal hysterectomy. The results provided by the first published studies demonstrate a significant decrease in symptoms in 70-95% of cases. The aim of our study was to compare the cost-effectiveness ratios for pelvic embolization and vaginal hysterectomy looked at from the hospital point of view.

[Acute gastro-enteritis in children in France: estimates of disease burden through national hospital discharge data].

Objectives: To estimate the burden of hospitalized infectious gastroenteritis of children younger than 5 years of age and associated costs.

Methods: We analyzed 1997 hospital discharges with a primary diagnosis of gastroenteritis or a secondary diagnosis of gastroenteritis with gastroenteritis symptoms or complications as primary diagnosis and compared the deaths with those of the national mortality data.

Results: Gastroenteritis was associated with 51,125 hospitalizations which accounted for 11.

Automated quantitative analysis of nocturnal jejunal motor activity identifies abnormalities in individuals and subgroups of patients with slow transit constipation.

Objective: Small bowel dysmotility has previously been demonstrated in some patients with slow transit constipation (STC), suggesting a generalized intestinal disorder. However, no study has addressed whether the incidence of small intestinal dysfunction differs between subgroups of patients in this heterogeneous population. Using appropriate methodology, we aimed to determine prospectively the proportion of individuals with abnormal small bowel motility, and to assess whether heterogeneity in terms of pattern of colonic transit delay (based on (111)In diethylene-triamine-pentaacetic acid (DTPA) isotope scintigraphy), or mode of onset (based on clinical history) is of importance.

Risk factors for cervical stenosis after laser cone biopsy.

Objective: To evaluate the incidence of cervical stenosis after laser cone biopsy and to identify risks factors for this adverse outcome.

Methods: Prospective study evaluating all patients (n = 375) treated by laser cone biopsy for suspected cervical intraepithelial neoplasia between 1 January 1990 and 31 December 1996. Patients were contacted by mail for a clinical evaluation, 37 +/- 26 months after surgery.

Cohort follow-up of couples with primary infertility in an ART programme using frozen donor semen.

Background: This study was designed to determine the crude cumulative live-birth rates in a cohort initiating frozen donor semen treatment until completion.

Methods: This cohort study included 588 couples with primary infertility in one University Hospital centre. The treatment sequence involved first artificial insemination (AID) followed by IVF if necessary (IVF-D).

[Epidemiology of apparently benign ovarian cysts].

The incidence of ovarian cysts in the general population is difficult to estimate. Certain cysts are functional and generally not operated, except in case of complications. Others are organic cysts which are usually, but not always operated.

Reproductive behaviour of HIV-infected women living in France, according to geographical origin.

Pregnancy rates were compared before and after HIV diagnosis according to geographical origin (sub-Saharan Africa versus Europe) among 533 HIV-infected women followed in the French SEROCO/SEROGEST cohorts between 1988 and 1996. Among European women, the incidence of deliveries and terminations decreased, respectively, by nearly twofold and fourfold after HIV diagnosis. Conversely, the pregnancy incidence increased among African women with fewer than two children.

[Medical and economic evaluation of organ transplantation in France. The example of liver transplantation].

Background: Organ transplantation is an expensive and risky medical procedure. Estimating the cost is difficult because the care is complex and involves many actors. We present a methodological framework for the economic evaluation of organ transplantation in France which include a detailed collection of all the direct costs and the simultaneous analysis of health status.

Evolution of clinical and radiological features at diagnosis of achalasia during a 19-year period in central France.

Objectives: Symptoms of achalasia are often misinterpreted, resulting in delayed diagnosis. The aims of our study were (1) to estimate the evolution of clinical and radiological features of a large population of achalasic patients between two successive periods; and (2) to determine the influence of symptoms on diagnostic delay.

Methods: Between 1980 and 1998, all achalasia patients treated in our unit were assessed at the time of manometric diagnosis for clinical and radiological features.

Costs and outcomes of liver transplantation in adults: a prospective, 1-year, follow-up study. GRETHECO study group.

Background: Orthotopic liver transplantation (OLT) is widely used to treat patients with end-stage liver disease. However, data on the cost of the procedure are fragmentary. We evaluated the costs, as calculated from resource use, and outcomes of OLT in adults, from registration on the transplant waiting list to the end of the 1st-year of follow-up after the transplant.

[The educated societies and the development of medical evaluation].

The French National Agency for Medical Evaluation (ANDEM) is regularly cooperating with scientific societies. In 1995, for the clinical guidelines and medical references program, ANDEM sent a request to 167 scientific societies. Societies were asked to select topics in which they had an involvement, to provide their guidelines, or recommendations they published, and to provide experts' names.