41 results match your criteria: "Centre hospitalier de Bretagne Sud[Affiliation]"

Background: The severity and course of sepsis-associated acute kidney injury (SA-AKI) are correlated with the mortality rate. Early detection of SA-AKI subphenotypes might facilitate the rapid provision of individualized care.

Patients And Methods: In this analysis of a multicenter prospective study, we combined conventional kidney function variables with serial measurements of urine (tissue inhibitor of metalloproteinase-2 [TIMP-2])* (insulin-like growth factor-binding protein [IGFBP7]) at 0, 6, 12, and 24 h) and then using an unsupervised hierarchical clustering of principal components (HCPC) approach to identify different phenotypes of SA-AKI.

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Prevalence and risk factors of significant persistent pain symptoms after critical care illness: a prospective multicentric study.

Crit Care

May 2023

Pôle Anesthésie Réanimations, Service d'Anesthésie Réanimation chirurgicale, Hôtel Dieu, Nantes Université, CHU Nantes, 44093, Nantes, France.

Article Synopsis
  • A multicentric study analyzed the prevalence and risk factors of persistent pain in patients who stayed in an ICU for 48 hours or more, revealing that 47.7% experienced significant pain three months post-admission.
  • Key risk factors for persistent pain included being female, previous use of antidepressants, specific positioning during care, and having pain symptoms at discharge.
  • Despite the high prevalence of pain, only 11.3% of patients received specialized pain management within three months, indicating a need for better pain management strategies in critical care settings.
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Article Synopsis
  • - Patients with oligometastatic prostate cancer (having up to 5 metastases) generally have a better prognosis than those with more extensive disease, making this a crucial area for treatment investigation.
  • - The study investigates whether combining stereotactic body radiotherapy (SBRT) with the immune checkpoint inhibitor durvalumab can improve progression-free survival in these patients compared to SBRT alone.
  • - This multicenter phase II trial will evaluate various outcomes, including quality of life and immune response, by enrolling 96 participants over three years, aiming to provide insights into better treatment strategies for prostate cancer.
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Background: To evaluate potential synergistic effect of pembrolizumab with radiotherapy (RT) compared with a standard-of-care (SOC) cetuximab-RT in patients with locally advanced-squamous cell carcinoma of head and neck (LA-SCCHN).

Patients And Methods: Patients with nonoperated stage III-IV SCC of oral cavity, oropharynx, hypopharynx, and larynx and unfit for receiving high-dose cisplatin were enrolled. Patients received once-daily RT up to 69.

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Objective: We investigated the efficacy and safety of afatinib maintenance therapy in patients with head and neck squamous cell carcinoma (HNSCC) with macroscopically complete resection and adjuvant radiochemotherapy (RCT).

Methods: This French multicentric randomised phase III double-blind placebo-controlled study included adult patients with ECOG-PS≤2, normal haematological, hepatic and renal functions, and non-metastatic, histologically confirmed HNSCC of the oral cavity, oropharynx, larynx or hypopharynx, with macroscopically complete resection and adjuvant RCT (≥2 cycles of cisplatin 100 mg/m2 J1, J22, J43 and 66Gy (2Gy/fraction, 5 fractions/week, conventional or intensity modulated radiotherapy ≥60Gy). Randomised patients were planned to receive either afatinib (afa arm) or placebo (control arm (C)) as maintenance therapy for one year.

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Background: Randomized trials comparing the first-generation absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, CA, USA) with a drug-eluting stent showed a moderate but significant increase in the rate of 3-year major adverse cardiac events and scaffold thrombosis, followed by a decrease in adverse events after 3 years.

Aim: The objective of this study was to assess the 5-year outcomes of patients treated with at least one absorb BVS and included in the FRANCE ABSORB registry.

Methods: All patients treated in France with an absorb BVS were prospectively included in a large nationwide multicentre registry.

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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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Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): an open-label, randomised, phase 3 trial.

Lancet Oncol

January 2022

International Center for Thoracic Cancers, and Department of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France; Oncostat Unité Mixte de Recherche 1018, Inserm, University Paris-Saclay, labeled Ligue Contre le Cancer, Villejuif, France.

Background: In patients with non-small-cell lung cancer (NSCLC), the use of postoperative radiotherapy (PORT) has been controversial since 1998, because of one meta-analysis showing a deleterious effect on survival in patients with pN0 and pN1, but with an unclear effect in patients with pN2 NSCLC. Because many changes have occurred in the management of patients with NSCLC, the role of three-dimensional (3D) conformal PORT warrants further investigation in patients with stage IIIAN2 NSCLC. The aim of this study was to establish whether PORT should be part of their standard treatment.

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Assessment of SARS-CoV-2 testing in children during a low prevalence period (VIGIL study 1).

Infect Dis Now

September 2021

ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 31, rue Le Corbusier, 94000 Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association française de Pédiatrie Ambulatoire, Saint-Germain-en-Laye, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.

Objectives: SARS-CoV-2 induces a broad spectrum of clinical manifestations, which overlap with other viral infections very common in children. We aimed to describe the percentage of positive SARS-CoV-2 RT-PCR tests in symptomatic and asymptomatic ambulatory children and to determine the predictive factors for positivity.

Patients And Methods: From June 1 to July 31, 2020, we conducted a cross-sectional prospective, multicenter study (13 hospital emergency units and 59 ambulatory pediatricians) throughout France.

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Prognostic Value and Relation with Adjuvant Treatment Duration of ctDNA in Stage III Colon Cancer: a Analysis of the PRODIGE-GERCOR IDEA-France Trial.

Clin Cancer Res

October 2021

Centre de Recherche des Cordeliers, INSERM, CNRS, Université de Paris, Sorbonne Université, USPC, Equipe labellisée Ligue Nationale Contre le Cancer, SIRIC CARPEM, Paris, France.

Purpose: Circulating tumor DNA (ctDNA) has been suggested as a major prognostic factor in resected stage-III colon cancer. We analyzed ctDNA of patients randomized in the phase III IDEA-France trial.

Experimental Design: ctDNA was tested for and by droplet digital PCR with method developed and validated for colorectal cancer.

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Background: Results from a phase 2 trial of the TPEx chemotherapy regimen (docetaxel-platinum-cetuximab) showed promising results, with a median overall survival of 14·0 months in first-line recurrent or metastatic head and neck squamous-cell carcinoma (HNSCC). We therefore aimed to compare the efficacy and safety of the TPEx regimen with the standard of care EXTREME regimen (platinum-fluorouracil-cetuximab) in this setting.

Methods: This was a multicentre, open-label, randomised, phase 2 trial, done in 68 centres (cancer centres, university and general hospitals, and private clinics) in France, Spain, and Germany.

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Background: Few data have been published on the clinical and histopathological characteristics of advanced non-small-cell lung cancer (NSCLC) patients with high PD-L1 expression versus intermediate or none and the prognostic value of PD-L1 expression for patients treated with chemotherapy is unknown. This study was undertaken to prospectively assess the prognostic value of tumor-cell (TC) and immune-cell (IC) PD-L1 expressions for advanced NSCLC patients.

Methods: It was a prospective, multicenter study on advanced NSCLC patients, with performance status 0/1, scheduled, consecutively, to receive first-line platin-based chemotherapy.

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Streptococcus pyogenes or group A Streptococcus (GAS) causes diseases ranging from uncomplicated pharyngitis to life-threatening infections. It has complex epidemiology driven by the diversity, the temporal and geographical fluctuations of the circulating strains. Despite the global burden of GAS diseases, there is currently no available vaccination strategy against GAS infections.

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Introduction: In intensive care unit (ICU), the decision of extubation is a critical time because mortality is particularly high in case of reintubation. To reduce that risk, guidelines recommend to systematically perform a spontaneous breathing trial (SBT) before extubation in order to mimic the postextubation physiological conditions. SBT is usually performed with a T-piece disconnecting the patient from the ventilator or with low levels of pressure-support ventilation (PSV).

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Article Synopsis
  • Debio 1143 is a novel oral drug that potentially boosts the effectiveness of cisplatin and radiotherapy in treating high-risk locally advanced squamous cell carcinoma of the head and neck by activating specific immune pathways.
  • The study involved a randomized, double-blind design with participants receiving either Debio 1143 or a placebo alongside standard chemoradiotherapy across 19 hospitals in France and Switzerland.
  • Researchers aimed to evaluate the safety and efficacy of the treatment, focusing on how many patients maintained locoregional control 18 months post-therapy, using established cancer response criteria.
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Background: The urine biomarkers tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been validated for predicting and stratifying AKI. In this study, we analyzed the utility of these biomarkers for distinguishing between transient and persistent AKI in the early phase of septic shock.

Methods: We performed a prospective, multicenter study in 11 French ICUs.

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Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer.

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Objectives: To evaluate reliability and feasibility of the respiratory variability of pulmonary velocity-time integral as a new dynamic marker of fluid responsiveness in mechanically ventilated patients.

Design: Prospective observational study.

Setting: Medical-surgical ICU of a general hospital.

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[Features distinguishing ornithosis from avian acute hypersensitivity pneumonitis - a retrospective analysis].

Rev Mal Respir

March 2019

Service des maladies infectieuses et de réanimation médicale, CHU de Rennes, 35043 Rennes, France; Inserm-CIC-1414, faculté de médecine, IFR 140, université de Rennes I, 35033 Rennes, France.

Introduction: The aim of our study was to compare the features at diagnosis in patients with ornithosis to patients with avian acute hypersensitivity pneumonitis (HP). Clinical, biological and radiological differences could potentially help clinicians to distinguish these diseases.

Methods: We conducted a retrospective study on patients admitted from 2000 to 2016 in three hospitals.

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Should 45,X/46,XY boys with no or mild anomaly of external genitalia be investigated and followed up?

Eur J Endocrinol

September 2018

Pediatric Endocrinology Department, CHU Robert Debré, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Assistance-Publique Hôpitaux de Paris and Université Paris Diderot, Sorbonne Paris Cité, Paris, France.

Article Synopsis
  • - The study investigates the clinical outcomes of boys with 45,X/46,XY mosaicism who have a normal or slightly abnormal male phenotype, focusing on their growth and puberty development from 1982 to 2017.
  • - Results show that many of these boys experience stunted growth and related health issues, with about 70% exhibiting features similar to Turner syndrome and most experiencing puberty but with declining testicular function.
  • - The findings highlight the importance of early diagnosis and continuous monitoring of these patients to manage potential fertility issues, as many are diagnosed later in life with conditions like azoospermia.
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[Misdiagnosis of hidradenitis suppurativa continues to be a major issue. The R-ENS Verneuil study].

Ann Dermatol Venereol

May 2018

ResoVerneuil, France; Service de dermatologie, polyclinique Courlancy, 38 bis, rue de Courlancy, 51100 Reims, France.

Objective: To provide physicians with an understanding of the factors behind significant delays in the diagnosis of hidradenitis suppurativa (HS) in France.

Patients And Methods: This prospective multicentre national study conducted from October 2015 to March 2016 included all patients consulting for HS. Patient data were collected by means of a standardized questionnaire.

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Background: Intensive haemodialysis (IHD) in addition to bortezomib-based chemotherapy might be efficient to rapidly decrease serum immunoglobulin-free light chains removal in patients with multiple myeloma (MM) and to improve renal prognosis and survival.

Methods: The aim of this retrospective multi-centre study was to compare the efficacy (renal recovery rate) of IHD and of standard haemodialysis (SHD) in patients with MM and dialysis-dependent acute kidney injury (AKI), concomitantly treated with bortezomib-based chemotherapy.

Results: We selected 41 patients with MM and dialysis-dependent AKI, most likely due to myeloma cast nephropathy (MCN), and who were treated in eight French hospitals between January 2007 and June 2011.

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Introduction: Radiotherapy can diminish quality of life (QoL) for prostate cancer patients. Our objective was to evaluate the effect of radiotherapy on QoL in men aged 75 years or older treated with radiotherapy for a localized prostate cancer, and to identify predictors of reduced QoL.

Patients And Methods: We prospectively administered a battery of geriatric (MNA, GDS, Get up and Go Test, CIRS-G, ADL, IADL, MMSE), toxicity (IPSS; IIEF 5), and QoL (QLQ C30) screening tests in 100 elderly patients before and two months after prostate cancer radiotherapy (NCT 02876237).

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