317 results match your criteria: "Centre hospitalier Annecy-Genevois[Affiliation]"

Article Synopsis
  • MDS-RS patients experience chronic anemia and often become dependent on red blood cell transfusions, with a low risk of developing acute myeloid leukemia.
  • In a 6-month study involving 100 transfusion-dependent patients across 12 French centers, researchers examined transfusion patterns, hospitalization frequency, care costs, and related health issues.
  • Results showed that 79% of patients had a high transfusion burden, leading to increased hospital visits and significant treatment costs (16,188€ per patient), highlighting the need to evaluate more effective treatment options.
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Background: In the observational SUPER-MIMI study, a minimalist immediate mechanical intervention (MIMI) technique-which involves restoring blood flow in the acute phase and postponing stenting-was shown to be safe and effective among patients with a high thrombotic burden after ST-segment elevation myocardial infarction (STEMI). We aim to assess whether a non-stenting strategy after a SUPER-MIMI strategy was safe at 4-year follow-up in patients enrolled in the SUPER-MIMI study who were not stented.

Methods: This prospective cohort study assessed the long-term outcomes of a subgroup of patients included in the SUPER-MIMI study.

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Article Synopsis
  • The research focuses on assessing the rate of avoidable 30-day readmissions for patients hospitalized with community-acquired pneumonia (CAP) and highlights the lack of a clear definition for what constitutes an avoidable readmission.
  • Conducted as a cohort study in two French hospitals, the analysis looked at clinical records from 2014 and involved reviews by board-certified physicians to determine whether readmissions were avoidable based on specific criteria.
  • Out of 1,150 patients hospitalized for CAP, 9.4% experienced unplanned readmissions, and the study found that 13.9% of these were deemed potentially avoidable, indicating room for improvement in hospital care and discharge planning.
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Introduction: Expanded-criteria donors (ECDs) are used to reduce the shortage of kidneys for transplantation. However, kidneys from ECDs are associated with an increased risk of delayed graft function (DGF), a risk factor for allograft loss and mortality. HYPOREME will be a multicentre randomised controlled trial (RCT) comparing targeted hypothermia to normothermia in ECDs, in a country where the use of machine perfusion for organ storage is the standard of care.

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Article Synopsis
  • The study investigates whether high-flow nasal oxygen (HFNO) alone can reduce 28-day mortality in immunocompromised patients with acute respiratory failure compared to a combination of HFNO and non-invasive ventilation (NIV).
  • The FLORALI-IM trial includes adults in 29 ICUs, utilizing random assignment to either HFNO alone or alternating between NIV and HFNO, with strict exclusion criteria for certain severe conditions.
  • The goal is to evaluate the effectiveness of HFNO alone as a potentially safer alternative to NIV for patients with serious respiratory issues.
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Background: Increasing numbers of patients with cardiac implantable electronic devices (CIEDs) are undergoing radiotherapy (RT) for cancer. The aim of the study was to prospectively evaluate the incidence, characteristics, and associated factors of CIED dysfunctions related to RT.

Methods: Between April 2013 and March 2020, all patients with a CIED who underwent ≥1 RT session were enrolled.

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Background: Management of patients with multiple chronic diseases is a growing public health challenge, especially in rural sectors where access to physicians may be limited. Connected medical devices monitoring vital signs, associated with eHealth program and structured telephone support, may improve complex patient management through early detection of disease complications, positive impact on patients' health, and health resources consumption optimization.

Objective: The aim of this study was to evaluate the technical performance and user experience of the NOMHAD eHealth system in patients with multimorbidity.

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Purpose: Acute mesenteric ischemia (AMI) is a rare, but life-threatening condition occurring among critically ill patients. Several factors have been associated with AMI, but the causal link is debated, most studies being retrospective. Among these factors, enteral nutrition (EN) could be associated with AMI, in particular among patients with shock.

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Critical pathways for controlled donation after circulatory death in France.

Anaesth Crit Care Pain Med

April 2022

Agence de la biomédecine, Medical and Scientific Department, 1, avenue du stade de France, 93212 Saint-Denis, France.

Introduction: In 2015, France authorised controlled donation after circulatory death (cDCD) according to a nationally approved protocol. The aim of this study is to provide an overview from the perspective of critical care specialists of cDCD. The primary objective is to assess how the organ donation procedure affects the withdrawal of life-sustaining therapies (WLST) process.

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Article Synopsis
  • - The study examined the epidemiological and economic burden of severe influenza in France across eight influenza seasons from 2010 to 2018, revealing that influenza causes 2-6 million cases annually, often leading to hospitalizations and deaths.
  • - Researchers utilized data from the French hospital information database and models to estimate hospitalization rates, mortality, and associated medical costs, finding an average of nearly 19,000 hospitalizations per season, with significant burdens felt by individuals aged 65 and older.
  • - Results indicated that 70% of related hospitalizations and 90% of excess mortality occurred in those aged 65+, emphasizing the considerable impact of influenza and its complications on public health, particularly for older adults.
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Radiotherapy for patient with cardiac implantable electronic device, consensus from French radiation oncology society.

Cancer Radiother

February 2022

Service d'oncologie radiothérapie, hôpital européen Georges-Pompidou, Université de Paris, 20, rue Leblanc, 75015 Paris, France.

Radiotherapy in patients with cardiac implantable electronic device such as pacemakers or defibrillators, is a clinical situation that is becoming increasingly common. There is a risk of interaction between the magnetic field induced by accelerators and the cardiac implantable electronic device, but also a risk of device dysfunction due to direct and/or indirect irradiation if the cardiac implantable electronic device is in the field of treatment. The risk can be dose-dependent, but it is most often independent of the total dose and occurs randomly in case of neutron production (stochastic effect).

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[Stress fracture of the neck of the femur during pregnancy: A rare clinical situation].

Gynecol Obstet Fertil Senol

March 2022

Département de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble-Alpes, Quai Yermoloff 38700 La Tronche, France.

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Background: The optimal treatment duration of ICIs for patients with advanced NSCLC remains uncertain. In phase 3 clinical trials, treatment continued for 2 years or until disease progression with similar long-term survival rates. Real-life data are missing.

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Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease.

J Am Coll Cardiol

November 2021

Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France.

Article Synopsis
  • The FUTURE trial investigated whether using fractional flow reserve (FFR) to guide treatment in multivessel coronary artery disease (CAD) is more effective than traditional approaches.
  • The study was a randomized trial involving 927 patients, comparing outcomes of an FFR-guided strategy with a standard strategy without FFR, focusing on major adverse cardiac events over one year.
  • Results showed no significant differences in major adverse events or mortality between the two groups, indicating that FFR guidance did not provide a clear benefit in managing multivessel CAD.
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Objective: To evaluate the efficacy and safety of regorafenib versus tamoxifen in platinum-sensitive ovarian cancer biological recurrence, defined by CA-125 increase without radiological (RECIST criteria) or symptomatic evidence of progression.

Patients And Methods: 116 patients with platinum-sensitive ovarian cancer presenting an isolated increase of CA-125 were planned to be randomized. Regorafenib was administered orally at 160 or 120 mg daily, 3 weeks on/1 week off or tamoxifen at 40 mg daily, until disease progression or development of unacceptable toxicity.

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Vaccination for Respiratory Infections in Patients with Heart Failure.

J Clin Med

September 2021

Cardiology Department, INI-CRT, CHU de Montpellier, PhyMedExp, Université de Montpellier, INSERM, CNRS, 34295 Montpellier, France.

Article Synopsis
  • * There is a need for more research on the effectiveness of influenza and pneumococcal vaccines, as well as the COVID-19 vaccine, in preventing heart-related issues in HF patients; current guidelines recommend annual vaccinations.
  • * To enhance vaccination rates among HF patients, a coordinated health policy involving various healthcare professionals is necessary, as implementation of existing vaccination recommendations has been lacking.
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Benzodiazepines have proven to be highly effective for treating insomnia and anxiety. Although considered safe when taken for a short period of time, a major risk-benefit dilemma arises in the context of long-term use, relating to addiction, withdrawal symptoms, and potential side effects. For these reasons, benzodiazepines are not recommended for treating chronic sleep disorders, anxiety disorders, nor for people over the age of 65, and withdrawal among long-term users is a public health issue.

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Background: Acute respiratory distress syndrome (ARDS) is a severe complication of COVID-19 pneumonia, with a mortality rate amounting to 34-50% in moderate and severe ARDS, and is associated with prolonged duration of invasive mechanical ventilation. Such as in non-COVID ARDS, harmful mechanical ventilation settings might be associated with worse outcomes. Reducing the tidal volume down to 4 mL kg of predicted body weight (PBW) to provide ultra-low tidal volume ventilation (ULTV) is an appealing technique to minimize ventilator-inducted lung injury.

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Article Synopsis
  • A survey of 74 nursing homes in the French Alps from March to May 2020 analyzed the spread of COVID-19 among residents and staff during the pandemic.
  • Out of 5,891 residents, the COVID-19 incidence was 8.2%, with 22 facilities reporting outbreaks of at least three cases, while 4,652 staff had a 6.3% incidence rate.
  • A strong correlation was found between staff and resident COVID-19 cases, indicating that staff were likely a major source of transmission, regardless of the homes' characteristics or mitigation efforts.
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Background: The optimal management of patients with ST-segment elevation myocardial infarction (STEMI) presenting late->12 hours following symptom onset-is still under debate.

Objectives: The purpose of this study was to describe characteristics, temporal trends, and impact of revascularization in a large population of latecomer STEMI patients.

Methods: The authors analyzed the data of 3 nationwide observational studies from the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) program, conducted over a 1-month period in 2005, 2010, and 2015.

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Background: CASSIOPEIA part 1 showed superior depth of response and significantly improved progression-free survival with daratumumab, bortezomib, thalidomide, and dexamethasone (D-VTd) versus bortezomib, thalidomide, and dexamethasone (VTd) as induction and consolidation in patients with autologous stem-cell transplant (ASCT)-eligible newly diagnosed multiple myeloma. In part 2, we compared daratumumab maintenance versus observation only.

Methods: CASSIOPEIA is a two-part, open-label, randomised, phase 3 trial of patients aged 18-65 years with newly diagnosed multiple myeloma and Eastern Cooperative Oncology Group performance status 0-2, done in 111 European academic and community practice centres.

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Background: Guidelines recommend to consider excluding non-ST-segment elevation myocardial infarction (NSTEMI) when high-sensitivity cardiac troponin is below the limit of quantification and a single blood sample is taken > 6 h after the onset of chest pain. The aim of our study was to assess such exclusion when a single blood sample was taken 3-6 h after the onset of permanent chest pain.

Methods: This observational study included consecutive patients admitted into the emergency room of our hospital with chest pain and suspected NSTEMI, with non-contributive electrocardiograms and a single high-sensitivity cardiac troponin I (hs-cTnI) blood sample taken 3-6 h after the onset of chest pain and hs-cTnI < 4 ng/l (Abbott Diagnostic).

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Vaccination is the most efficient way to fight the Covid epidemic. However, suspicion of severe hypersensitivity to PEG (PolyEthylen Glycol) usually constitutes a vaccine contraindication. We report the case of a patient with a proven allergy to PEG and skin sensitization to the COMIRNATY vaccine (PEG in its composition).

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