47 results match your criteria: "Centre Hospitalier de Roanne.[Affiliation]"

[Bronchiolitis obliterans organizing pneumonia after radiotherapy: A systematic review and case report].

Cancer Radiother

December 2024

Département de radiothérapie, CHU de Saint-Étienne, Saint-Priest-en-Jarez, France; Département de radiothérapie, centre hospitalier de Roanne, Roanne, France. Electronic address:

Purpose: Bronchiolitis obliterans with pneumonic organization, or organizing pneumonia (OP), is an inflammatory disorder of the lungs, which can be triggered following pulmonary attacks of infectious or non-infectious origin. The non-infectious origins of OP include various entities including connective tissue diseases, exposure to toxic substances, medications, autoimmune diseases, and thoracic radiotherapy. The objective of this article is to summarize the literature on post-radiotherapy organized pneumonia, its etiologies, its clinical and radiological characteristics, as well as its treatment.

View Article and Find Full Text PDF
Article Synopsis
  • Endotracheal intubation (ETI) is crucial for critically ill patients
  • , but it has risks like hypoxemia; preoxygenation is used to enhance safety but can have unreliable monitoring through standard pulse oximeters (SpO2).
  • The Oxygen Reserve Index (ORI)
  • is proposed as a more reliable continuous measure during preoxygenation, targeting an ORI value of at least 0.6 over one minute instead of the standard SpO2 100% goal to improve outcomes.
  • A trial with 950 critically ill adults
  • will compare ORI monitoring against standard SpO2 monitoring during ETI; outcomes include the lowest SpO2 during intubation and cognitive
View Article and Find Full Text PDF

Health Care Resource Use and Total Mortality After Hospital Admission for Severe COVID-19 Infections During the Initial Pandemic Wave in France: Descriptive Study.

JMIR Public Health Surveill

September 2024

Hospices Civils de Lyon, Hôpital de la Croix Rousse, Département d'Anesthésie-Réanimation, Douleur, Lyon, France.

Background: Little is known about post-hospital health care resource use (HRU) of patients admitted for severe COVID-19, specifically for the care of patients with postacute COVID-19 syndrome (PACS).

Objective: A list of HRU domains and items potentially related to PACS was defined, and potential PACS-related HRU (PPRH) was compared between the pre- and post-COVID-19 periods, to identify new outpatient care likely related to PACS.

Methods: A retrospective cohort study was conducted with the French National Health System claims data (SNDS).

View Article and Find Full Text PDF

Molecular Characterization of Primary Mediastinal Large B-Cell Lymphomas.

Cancers (Basel)

October 2023

Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France.

Since the description of primary mediastinal large B-cell lymphoma (PMBL) as a distinct entity from diffuse large B-cell lymphomas (DLBCL), numerous studies have made it possible to improve their definition. Despite this, this differential diagnosis can be challenging in daily practice. However, in some centers, PMBL may be treated according to a particular regimen, distinct from those used in DLBCL, emphasizing the importance of accurate identification at diagnosis.

View Article and Find Full Text PDF

Background: Hyperglycaemia is common in critically ill patients, but blood glucose and insulin management may differ widely among intensive care units (ICUs). We aimed to describe insulin use practices and the resulting glycaemic control in French ICUs. We conducted a multicentre 1-day observational study on November 23, 2021, in 69 French ICUs.

View Article and Find Full Text PDF

Outcomes in Patients With COVID-19 With Acute Encephalopathy and Coma: An International Prospective Study.

Neurology

May 2023

From the Intensive Care Unit (S.L., G.J., A.F., M. Paul, M.-C.d.-C.), Centre Hospitalier de Versailles-Site André Mignot, Le Chesnay; University Paris-Saclay (S.L., G.J.), UVSQ, INSERM, CESP, Team « PsyDev », Villejuif; IctalGroup (S.L., P.S., J.C., M.L., G.P., G.J., A. Galbois, O.L., P. Bailly, P. Beuret, C.B., A.S., A.M.), Le Chesnay, France; Anesthesiology and Surgical-Trauma Intensive Care (R.B.), University Clinic Hospital, Valencia; Department of Surgery (R.B.), University of Valencia, Spain; Neuro-Intensive Care Unit (N.E.), Rothschild Foundation Hospital, Paris, France; Anesthesiology and Intensive Care (R.M.-T.), Hospital Regional de Alta Especilidad del Bajío, Leon, Mexico; Intensive Care Unit (P.S.), Groupe Hospitalier Sud Ile de France, Melun; Medical ICU (S.B.), Cochin Hospital, AP-HP, Paris, France; Departments of Neurology and Neurosurgery (M. Pizzi, C.M.), University of Florida College of Medicine, Gainesville; Department of Neurology (C.M.), Yale University School of Medicine, New Haven, CT; Department of Neurology (C.M.), University of Utah, Salt Lake City; Intensive Care Unit (J.C.), Centre Hospitalier Intercommunal Toulon La Seyne sur Mer; Intensive Care Unit (B.Z.), Hôpital Foch, Suresnes; Réanimation Médicale (M.L.), CHU Dijon; Service de Médecine Intensive Réanimation (G.P.), Centre Hospitalier d'Argenteuil; Intensive Care Unit (A. Galbois), Claude Galien Private Hospital, Quincy-sous-Senart, Île-de-France; Réanimation Chirurgicale (Y.L.), Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire de Rennes; Hospices Civils de Lyon (L.A.), Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation; Université de Lyon (L.A.), Université Claude Bernard Lyon 1, Faculté de Médecine Lyon-Est; Service de Réanimation (O.L.), Centre Hospitalier de la Rochelle, Nouvelle-Aquitaine; Intensive Care Unit (A. Guillon), Tours University Hospital; INSERM UMR 1100 (Research Center for Respiratory Diseases) (A. Guillon), University of Tours; Médecine Intensive Réanimation (P. Bailly), CHU de Brest; Service de Réanimation et Soins Continus (P. Beuret), Centre Hospitalier de Roanne, Rhône-Alpes; Polyvalent ICU (S. Siami), Centre Hospitalier Sud Essonne Dourdan-Etampes, Paris; Médecine Intensive Réanimation (D.B.), Centre Hospitalier Régional d'Orléans; Médecine Intensive Réanimation (G.C.), District Hospital Center, La Roche-sur-Yon, France; Centro de Investigación Clínica (L.G.), and Adult Intensive Care Unit (J.L.A., J.M.), Fundación Valle del Lili, University Hospital, Cali, Colombia; Service de Réanimation (C.B.), Groupe Hospitalier Paris Saint Joseph; Service de Réanimation (A.S.), Institut Gustave Roussy, Villejuif, France; Service de Réanimation (N.S.), Hôpital Fleyriat, Bourg en Bresse; Service de Médecine Intensive Réanimation (G.G.), Hôpital Universitaire Ambroise-Paré, APHP, Boulogne-Billancourt, France; Department of Neurology (D.S., Evie Sobczak, Emily Swafford, K.O.P., A.A.), University of Miami, FL; Service d'Anesthésie Réanimation Chirurgicale (A.M.), Hôpital Henri Mondor, Creteil, Île-de-France; Department of Anesthesiology and Critical Care (M.H.), Beaujon Hospital, DMU Parabol, AP-HP. Nord, Paris; Critical Care Unit (S. Silva), University Teaching Hospital of Purpan, Toulouse Cedex 9; Toulouse NeuroImaging Center (S. Silva), Toulouse University, UMR INSERM/UPS 1214, UPS, France; and Intensive Care Unit (M.J.A.d.C.), Hospital Nossa Senhora de Lourdes (Antigo Hospital Alfa), Recife, Pernambuco, Brazil.

Background And Objectives: To report the prevalence of acute encephalopathy and outcomes in patients with severe coronavirus disease 2019 (COVID-19) and to identify determinants of 90-day outcomes.

Methods: Data from adults with severe COVID-19 and acute encephalopathy were prospectively collected for patients requiring intensive care unit management in 31 university or university-affiliated intensive care units in 6 countries (France, United States, Colombia, Spain, Mexico, and Brazil) between March and September of 2020. Acute encephalopathy was defined, as recently recommended, as subsyndromal delirium or delirium or as a comatose state in case of severely decreased level of consciousness.

View Article and Find Full Text PDF

Background: Thromboembolic events frequently complicate the course of malignancy and represent a major cause of morbidity and mortality in cancer patients. In contrast to chemotherapy and other systemic therapies, little is known about the impact of ionizing radiations on the incidence of venous thromboembolism (VTE) in cancer patients.

Methods: In the present prospective study, we aimed to investigate the incidence, management, and outcome of VTE in newly diagnosed cancer patients who received curative radiotherapy.

View Article and Find Full Text PDF

Introduction: Status epilepticus (SE) is a common life-threatening neurological emergency that can cause long-term impairments. Overall outcomes remain poor. Major efforts are required to clarify the epidemiology of SE and the determinants of outcomes, thereby identifying targets for improved management.

View Article and Find Full Text PDF

Unlabelled: Family members commonly have inaccurate expectations of patient's prognosis in ICU. Adding to classic oral information, a visual support, depicting day by day the evolution of the condition of the patient, improves the concordance in prognosis estimate between physicians and family members. The objective of this study was to evaluate the impact of this tool on symptoms of anxiety/depression of family members.

View Article and Find Full Text PDF

Background: Phase III clinical trials have demonstrated the merits of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI) in the treatment of non-small cell lung cancer (NSCLC) patients with EGFR-activating mutations. Using a cohort of unselected patients treated with erlotinib, we sought to further describe patient and tumour characteristics, and to evaluate their progression-free survival (PFS) and overall survival (OS).

Methods: Overall, 44 pulmonologists included patients with the required characteristics as follows: Stage IIIB-IV NSCLC, EGFR-activating mutation, age≥18 years, and having to start erlotinib therapy or receiving erlotinib therapy as the first-line TKI, regardless of treatment-line.

View Article and Find Full Text PDF
Article Synopsis
  • The text discusses a study aimed at evaluating non-invasive oxygenation treatments for ICU patients with acute respiratory failure who have do-not-intubate orders, focusing on quality of life and discomfort, not just survival.
  • It outlines a multicentre observational study comparing different oxygenation strategies: high-flow nasal oxygen therapy (HFOT), NIV switching with HFOT, and NIV with standard oxygen, with a goal to include at least 330 patients.
  • The study has received ethical approval, will involve informed consent from participants, and aims to publish findings in peer-reviewed journals with trial registration number NCT03673631.
View Article and Find Full Text PDF

Background: Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery.

View Article and Find Full Text PDF

Background: Self-stigma is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD).

View Article and Find Full Text PDF

[Docetaxel for octogerian metastatic castration-resistant prostate cancer patient: A multicentric ten years' experience].

Bull Cancer

February 2020

Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108, bis avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France.

Introduction: There is very few data about the management of elderly patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to analyze the management of patients aged 80 and over treated with docetaxel for a mCRPC.

Methods And Materials: Clinical and pathological characteristics of octogerians treated with docetaxel were collected retrospectively from 3 French centers from 2009 to 2019.

View Article and Find Full Text PDF

Objective: To assess appropriateness of end-of-life treatments provided to actively dying patients attending the emergency department of a primary care hospital.

Methods: Retrospective cohort study of patients who died in the emergency department of a French primary care hospital between January 2014 and January 2017. The deceased were identified through the admissions register.

View Article and Find Full Text PDF

Purpose: Endocrine therapy (ET) used to reduce the risk of recurrence in hormone receptor-expressing disease (75% of breast cancers) is associated with worsening of climacteric symptoms with a negative impact on quality of life (QoL). Homeopathy might allow a better management of hot flushes (HF).

Methods: In this multicenter randomized double-blind placebo-controlled phase III study ( ClinicalTrials.

View Article and Find Full Text PDF

New rare genetic variants of LMF1 gene identified in severe hypertriglyceridemia.

J Clin Lipidol

October 2019

INSERM U1060, Laboratoire Carmen, Université Lyon 1, INRA U1235, INSA de Lyon, CENS, Centre de Recherche en Nutrition Humaine Rhône Alpes, Villeurbanne, Oullins, France; Hospices Civils de Lyon, Hôpital Louis Pradel, Fédération d'endocrinologie, maladies métaboliques, diabète et nutrition, Bron, France. Electronic address:

Background: The LMF1 (lipase maturation factor 1) gene encodes a protein involved in lipoprotein lipase and hepatic lipase maturation. Homozygous mutations in LMF1 leading to severe hypertriglyceridemia (SHTG) are rare in the literature. A few additional rare LMF1 variants have been described with poor functional studies.

View Article and Find Full Text PDF

Active periodic electrograms in remote monitoring of pacemaker recipients: the PREMS study.

Europace

January 2019

Cardiology Unit, Polyclinique Saint-Laurent, 320 avenue Général George S. Patton, Rennes, France.

Article Synopsis
  • Remote monitoring (RM) is now standard care for pacemaker patients, with the study focusing on the advantages of active intracardiac electrogram (aIEGM) recordings over passive ones.
  • An observational trial (PREMS) included 567 patients and found that 29.4% of aIEGMs showed significant anomalies not detectable by other RM methods, and many of these cases required corrective actions.
  • The aIEGM allowed for a comprehensive assessment of the pacemaker's sensing and pacing functions in 77.3% of cases, compared to just 15.5% with passive IEGM, indicating a significant improvement in remote pacemaker follow-up.
View Article and Find Full Text PDF

Background: Identifying patients at high risk of post-extubation acute respiratory failure requiring respiratory or mechanical cough assistance remains challenging. Here, our primary aim was to evaluate the accuracy of easily collected parameters obtained before or just after extubation in predicting the risk of post-extubation acute respiratory failure requiring, at best, noninvasive mechanical ventilation (NIV) and/or mechanical cough assistance and, at worst, reintubation after extubation.

Methods: We conducted a multicenter prospective, open-label, observational study from April 2012 through April 2015.

View Article and Find Full Text PDF

Objectives: In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians to decide early. We aimed to identify factors associated with intubation in patients with acute hypoxemic respiratory failure treated with different noninvasive oxygenation techniques.

View Article and Find Full Text PDF

[Macrophage activation syndrome and Kawasaki disease: Four new cases].

Arch Pediatr

July 2017

Unité d'immuno-hématologie et oncologie pédiatrique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.

Macrophage activation syndrome (MAS) is a rarely reported complication of Kawasaki disease (KD). It must be sought during KD with unusual clinical signs, such as enlargement of the liver or spleen, cytopenia (including thrombocytopenia), and elevated serum triglycerides. Here, we report four cases from a single center.

View Article and Find Full Text PDF

Objective: The increased bacterial resistance to antibiotics has now become a public health concern. How can we preserve the well-being of patients presenting with infections caused by extensively drug-resistant bacteria (EDRBs) and that of their contacts without inducing any loss of chance of survival, all the while living together and controlling the spread of these EDRBs?

Method: Terre d'éthique, a French territorial ethics committee, was asked to reflect on this topic by the infection control unit of a French University Hospital as it raises many ethical issues.

Results: Patients are at the core of any ethical approach, and respecting their autonomy is fundamental.

View Article and Find Full Text PDF