1,005 results match your criteria: "Groupement hospitalier EST[Affiliation]"

Background: The embedded participant (EP) plays a key role during a full scale/high-fidelity simulation (HFS) session. He/she is expected to guide the learner towards the achievement of the educational objectives of the scenario. However, his/her influence on learners' performance stands undetermined and this effect remains briefly addressed in the literature.

View Article and Find Full Text PDF

Aims: Struma ovarii (SO) are rare, accounting for 0.3-1% of ovarian tumours, and include benign and malignant lesions. In most cases, histology is not predictive of clinical outcome and prognosis.

View Article and Find Full Text PDF

Objective: N-methyl-d-aspartate (NMDA) receptors are expressed at synaptic sites, where they mediate fast excitatory neurotransmission. NMDA receptors are critical to brain development and cognitive function. Natural variants to the GRIN1 gene, which encodes the obligatory GluN1 subunit of the NMDA receptor, are associated with severe neurological disorders that include epilepsy, intellectual disability, and developmental delay.

View Article and Find Full Text PDF

Prevalence and clinical correlations of SF3B1 variants in lactotroph tumours.

Eur J Endocrinol

September 2023

Medizinische Klinik und Poliklinik IV, LMU Klinikum, LMU München, Munich 80336, Germany.

Article Synopsis
  • A study investigated the prevalence of SF3B1 gene mutations in lactotroph tumors across 282 patients from eight European centers, finding a low overall mutation rate of 2.5%, but a striking 50% prevalence in metastatic cases.
  • Seven patients had detected variants, including a new mutation linked to aggressive tumors, and mutations were found in both primary tumors and metastases in certain cases.
  • The presence of SF3B1 variants was associated with larger tumor size, higher proliferation rates, and poorer clinical outcomes, indicating their potential role in tumor aggressiveness and treatment challenges.
View Article and Find Full Text PDF

Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe.

ESMO Open

October 2023

Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.

Article Synopsis
  • Testing for EGFR mutations is crucial for metastatic non-squamous non-small-cell lung cancer, but practical challenges like access to testing and limited tissue samples hinder routine biomarker testing in European labs.
  • A validated online survey conducted among 64 expert labs revealed varying turnaround times and testing practices, with a significant portion only conducting EGFR testing upon clinician request.
  • Despite these issues, testing rates remained stable during the COVID-19 pandemic, but overall there is significant variability in testing methods and quality assurance across different European laboratories.
View Article and Find Full Text PDF

Background: This study aimed to collect obstetric anesthesia practice and patient-reported outcomes as an update to the last French Obstetric Anesthesia survey from 1996.

Methods: Maternity units were randomly selected across France and surveyed for 7 consecutive days from February, 2016, to January, 2017. Data was gathered prospectively by questionnaires filled out by patients and anesthesia providers.

View Article and Find Full Text PDF

Viral hemorrhagic fevers (HF) are a group of acute febrile diseases with high mortality rates. Although hemostatic dysfunction appears to be a major determinant of the severity of the disease, it is still unclear what pathogenic mechanisms lead to it. In clinical studies it is found that arenaviruses, such as Lassa, Machupo, and Guanarito viruses cause HF that vary in symptoms and biological alterations.

View Article and Find Full Text PDF

[Ethical principles for the design of a clinical trial in oncology].

Bull Cancer

February 2024

Conférence nationale des comités de protection des personnes (CNCP), HCL, groupement hospitalier Est, 59, boulevard Pinel, 69500 Bron, France; Comité de protection des personnes Sud méditerranée IV, hôpital Saint-Eloi, 34295 Montpellier cedex 5, France.

Unlabelled: Clinical research in the area of cancer is of utmost importance in order to improve patient care, both in terms of overall survival and quality of life. The implementation of clinical trials on medicinal products, now falling under EU Regulation 536/2014, is conditioned on prior scientific authorisation from the French National Agency for the Safety of Medicines and Health Products and a favorable ethical opinion from a Research Ethics Committee (REC).

Objective: The objective of this work is to report on the main problematic issues identified during the evaluation of oncology dossiers by the REC in order to present the expected elements and thus optimise the evaluation procedures.

View Article and Find Full Text PDF

Assessment of three equations to calculate plasma LDL cholesterol concentration in fasting and non-fasting hypertriglyceridemic patients.

Clin Chem Lab Med

January 2024

UF Dyslipidémies, Service de Biochimie et de Biologie Moléculaire, Laboratoire de Biologie Médicale MultiSites, Hospices Civils de Lyon Bron, France.

Objectives: Low-density lipoprotein cholesterol (LDL-C) concentration was calculated for many years using the Friedewald equation, but those from Sampson and extended-Martin-Hopkins perform differently. Their accuracy in fasting hypertriglyceridemia and non-fasting state were compared and the clinical impact of implementing these equations on risk classification and on the setting of lipid treatment goals was assessed.

Methods: Seven thousand six standard lipid profiles and LDL-C concentrations measured after ultracentrifugation (uLDL-C) were retrospectively included.

View Article and Find Full Text PDF

Pituitary Tumor Centers of Excellence (PTCOE) should now include neuro-oncologic input.

Pituitary

October 2023

Department of Endocrinology, Pituitary Tumors Centers of Excellence (PTCOE) of Lyon and Center for Rare Pituitary Diseases (HYPO), Hôpital Louis Pradel, "Groupement Hospitalier Est" Hospices Civils de Lyon, Lyon, France.

View Article and Find Full Text PDF

This Consensus Statement from an international, multidisciplinary workshop sponsored by the Pituitary Society offers evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. Epidemiology and pathogenesis, clinical presentation of disordered pituitary hormone secretion, assessment of hyperprolactinaemia and biochemical evaluation, optimal use of imaging strategies and disease-related complications are addressed. In-depth discussions present the latest evidence on treatment of prolactinoma, including efficacy, adverse effects and options for withdrawal of dopamine agonist therapy, as well as indications for surgery, preoperative medical therapy and radiation therapy.

View Article and Find Full Text PDF

Pseudocystic inflammatory demyelinating lesions in multiple sclerosis: A clinical, radiological, and pathological description.

Mult Scler

September 2023

Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Bron, France.

Background: Pseudocystic inflammatory demyelinating lesions (PIDLs) are poorly described in MS and might represent a diagnostic challenge.

Objectives: We described the clinical, radiological, pathological, and follow-up characteristics of 13 PIDL in 9 MS patients.

Methods: We constituted a single-center retrospective case series of PIDLs in MS, defined on MRI as expansive cyst-like lesions, with a fluid-signal content, and a diameter of 1 cm or more.

View Article and Find Full Text PDF
Article Synopsis
  • - A retrospective national study analyzed the safety and outcomes of surgery for patients with metastatic lung neuroendocrine tumors, including 155 patients, with 41 undergoing surgery and 114 not.
  • - The study found a low complication rate of 4.9% in the surgical group and no postoperative deaths, with significant symptom improvement (42.5%) compared to the nonoperative group (14.4%).
  • - Although overall survival wasn’t reached in the surgical group, the nonoperative group's median survival was 4.3 years; factors like performance status and number of metastatic sites were linked to survival, while surgery itself didn't significantly impact survival.
View Article and Find Full Text PDF

In the 2022 fifth edition of the WHO Classification of Endocrine Tumours and of Central Nervous System Tumours, pituitary adenomas are reclassified as neuroendocrine tumours (NETs). This change confers an oncology label to neoplasms that are overwhelmingly benign. A comprehensive clinical classification schema is required to guide prognosis, therapy and outcomes for all patients with pituitary adenomas.

View Article and Find Full Text PDF

Position statement on the diagnosis and management of acromegaly: The French National Diagnosis and Treatment Protocol (NDTP).

Ann Endocrinol (Paris)

December 2023

Service d'endocrinologie, centre de référence des maladies rares de l'hypophyse HYPO, assistance publique-hôpitaux de Marseille (AP-HM), hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.

Article Synopsis
  • * The condition is characterized by specific symptoms related to a pituitary tumor, such as headaches and joint pain, and can lead to various complications including cardiovascular and metabolic issues.
  • * Diagnosis involves elevated IGF-I levels and imaging to identify the pituitary tumor; treatment typically starts with surgery, but medication and radiation may be necessary for some patients, and care is best administered by a specialized multidisciplinary team.
View Article and Find Full Text PDF
Article Synopsis
  • The TRANSHEMO project aimed to investigate how well adolescents and young adults with severe haemophilia adhere to healthcare, particularly during their transition from pediatric to adult care, viewing adherence as a key indicator of success in this process.
  • A study conducted from 2017-2019 included 277 participants and found that adolescents had a significantly higher adherence rate (82.2%) compared to young adults (61.2%), with factors like age, academic struggles, and mental health affecting adherence.
  • The findings suggest that tailored support and educational programs could help improve healthcare adherence among young adults with severe haemophilia.
View Article and Find Full Text PDF

Therapeutic targeting of the pituitary tumor microenvironment.

Pharmacol Ther

October 2023

Inserm U1052, CNRS UMR5286, Cancer Research Center of Lyon, Lyon, France; Lyon 1 University, Villeurbanne, France; Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, "Groupement Hospitalier Est" Hospices Civils de Lyon, Bron, France. Electronic address:

The tumor microenvironment (TME), the complex environment in which tumors develop, has been increasingly targeted for cancer treatment in recent years. Aggressive pituitary tumors and pituitary carcinomas have been so far targeted with immune-checkpoint inhibitors (28 cases, including a large cohort), and anti-angiogenic drugs (34 cases), specifically bevacizumab (30 cases), sunitinib (three cases), and apatinib (one case). Here, we reviewed all these cases, reporting tumor response, potential predictors of response, as well as adverse events.

View Article and Find Full Text PDF

Prenatal diagnosis of microcephaly with simplified gyral pattern: series of eight cases.

Ultrasound Obstet Gynecol

February 2024

Pediatric and Fetal Imaging Department, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France.

Microcephaly with simplified gyral pattern (MSG) is an intrinsic genetic central nervous system disorder, characterized by microcephaly (a reduction of brain volume) and a simplified gyral pattern (a reduced number of gyri and shallow sulci associated with normal cortical thickness and neuroanatomical architecture), related to a reduced number of neuronal progenitors in the germinal matrix. We report the first prenatal series of MSG and define the prenatal imaging pattern, which should inform diagnosis and guide prenatal counseling in cases of fetal microcephaly. In this single-center retrospective study of fetuses with MSG, we assessed features on ultrasound and magnetic resonance imaging (MRI), as well as genetic and neuropathological/postnatal data.

View Article and Find Full Text PDF

Fifty years of research on mitochondrial fatty acid oxidation disorders: The remaining challenges.

J Inherit Metab Dis

September 2023

Biochemical and Molecular Biology Laboratory, Metabolic Inborn Errors of Metabolism Unit, Groupement Hospitalier Est, CHU de Lyon, Bron, France.

Since the identification of the first disorder of mitochondrial fatty acid oxidation defects (FAOD) in 1973, more than 20 defects have been identified. Although there are some differences, most FAOD have similar clinical signs, which are mainly due to energy depletion and toxicity of accumulated metabolites. However, some of them have an unusual clinical phenotype or specific clinical signs.

View Article and Find Full Text PDF

Autosomal dominant Zellweger spectrum disorder caused by de novo variants in PEX14 gene.

Genet Med

November 2023

Amsterdam UMC - AMC, Department of Laboratory Medicine, Laboratory Genetic Metabolic Diseases, Amsterdam, The Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.

Purpose: Zellweger spectrum disorders (ZSDs) are known as autosomal recessive disorders caused by defective peroxisome biogenesis due to bi-allelic pathogenic variants in any of at least 13 different PEX genes. Here, we report 2 unrelated patients who present with an autosomal dominant ZSD.

Methods: We performed biochemical and genetic studies in blood and skin fibroblasts of the patients and demonstrated the pathogenicity of the identified PEX14 variants by functional cell studies.

View Article and Find Full Text PDF

Objectives: Inaugural axial muscle involvement, defined as dropped head syndrome (DHS) and/or camptocormia (CC), is poorly described in inflammatory myopathies (IM). This study aimed to further characterize IM patients with inaugural DHS/CC, their outcome and care management.

Methods: This retrospective study included IM patients diagnosed between 2000 and 2021.

View Article and Find Full Text PDF