Clinical value of circulating endothelial cells and circulating tumor cells in metastatic breast cancer patients treated first line with bevacizumab and chemotherapy.

Background: We investigated whether circulating tumor cells (CTCs) and circulating endothelial cells (CECs) predict clinical outcome of first-line chemotherapy combined with bevacizumab in metastatic breast cancer patients.

Patients And Methods: In a French substudy of the MO19391 trial, CTC and CEC counts (CellSearch system) at baseline and changes after two cycles of treatment were correlated with time to progression (TtP).

Results: CTC and CEC levels were not correlated in the 67 patients included.

C-reactive protein improves risk prediction in patients with acute coronary syndromes.

Aims: Elevated C-reactive protein level is a risk marker in patients with acute coronary syndromes (ACSs), but current risk score systems do not consider this factor. We studied the incremental predictive value of adding C-reactive protein to the Global Registry of Acute Coronary Events (GRACE) risk score.

Methods And Results: Characteristics, treatments and 30-day mortality were recorded for 1408/1901 consecutive ACS patients.

Usefulness of antimicrobial resistance pattern for detecting PVL- or TSST-1-producing meticillin-resistant Staphylococcus aureus in a French university hospital.

Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton-Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing.

Evidence for anti-tumour effect of allogeneic haematopoietic SCT in cases without sustained donor engraftment.

Remissions of haematological malignancies have been reported after allo-SCT, despite donor cell rejection, suggesting that sustained allogeneic engraftment is not mandatory to obtain a lasting anti-tumour effect. To evaluate the potential benefit from transient post-allo-SCT alloreactivity, we took advantage of the Société Française de Greffe de Moëlle et Thérapie Cellulaire (SFGM-TC) registry to colligate 14 patients with an efficient and long-lasting allogeneic (GVL) effect after allo-SCT for haematological malignancies, despite transient or absent engraftment. None received a second allogeneic graft after autologous recovery.

Ecological study of the effectiveness of isolation precautions in the management of hospitalized patients colonized or infected with Acinetobacter baumannii.

Objective: To assess the impact of isolation precautions on the incidence of patients colonized or infected with Acinetobacter baumannii (case patients) in a university hospital during the period from 1999 to 2006.

Design: Ecological study.

Setting: The Besançon University Hospital in France, a 1,200-bed acute care hospital with approximately 50,000 admissions per year.

[Ropivacaine infiltration during breast cancer surgery: postoperative acute and chronic pain effect].

Objectives: Decrease acute pain after breast cancer surgery by an infiltration of ropivacaine. Analyse effect on chronic pain.

Study Design: Prospective randomised double blind versus placebo study.

[Takotsubo syndrome: a young woman case].

After induction of anaesthesia for lumbar disc herniation surgery, an ASA-1, 39-year-old woman presented an acute heart failure. A persistent hypotension with tachycardia was observed after a brief hypertension peak during orotracheal intubation. After electrocardiogram, echocardiogram and biologic dosages, the diagnosis seems to be coronary ischemia.

Main anatomical features of the M1 segment of the middle cerebral artery: a 3D time-of-flight magnetic resonance angiography at 3 T study.

The purpose of our study was to determine the main anatomical features of the M1 segment of middle cerebral artery (MRA) using a 3D TOF-MRA at 3 T. Reconstructed and post-processed MRA images were independently analysed by two anatomists in order to determine the course patterns, the division patterns and the early cortical branches patterns of the M1 segments. The division patterns were defined as bipode, tripode or other.

Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection.

Catheter-associated urinary tract infection (CAUTI) is one of the most common types of nosocomial infection. Reducing the duration of catheterization may be a key intervention in CAUTI prevention. We carried out a prospective time-sequence, non-randomized intervention study in five departments of our university hospital.

[Pemetrexed development in oncology].

The pemetrexed disodium (Alimta), LY231514) is the first antifolate able to inhibit at the same time the synthesis of purins and pyrimidins. Many therapeutic tests were carried out in clinical situations where the methotrexate and the fluorouracil had been the proof of their effectiveness. It then showed an interesting activity in a great number of tumours but with very different profiles of tolerance according to the studies and pathologies.

Pontomedullary sulcus infarct: a variant of lateral medullary syndrome.

With the advent of magnetic resonance imaging (MRI) technology, it is now possible to identify and determine the precise location of medullary infarcts. The lateral part of the medulla is most commonly affected by infarction. Classifications of lateral medullary infarcts are usually based on anatomical data, using rostrocaudal and dorsoventral axes to establish correlations with clinical symptoms.

Effect of individual- and group-level antibiotic exposure on MRSA isolation: a multilevel analysis.

Objectives: To observe the relative role of individual and group-level antimicrobial selective pressure on subsequent methicillin-resistant Staphylococcus aureus (MRSA) isolation in a university hospital.

Methods: For this purpose, 18 596 patients were included in a retrospective statistical analysis, applying multilevel modelling with discrete time intervals at the lowest level. Individual-level and hospital group variables on antimicrobial exposure and MRSA colonization pressure were collected from computerized databases.

[Induction chemotherapy in patients with head and neck cancer].

Neoadjuvant chemotherapies for patients with advanced head and neck squamous cell carcinoma have been widely studied for twenty years. Despite a high level of activity on the primary tumor, no study has demonstrated a survival benefit suggesting the use of neoadjvant chemotherapy. One can consider that the only benefit of such strategy is for larynx preservation in patients with operable hypopharnx or larynx cancer.

[Are isolation measures needed in the hospital management of Acinetobacter baumannii colonizations-infections?].

Unlabelled: Until 2001, the infection control department of the Besançon university hospital (France) recommended isolation precautions for all patients colonized-infected by Acinetobacter baumannii (Ab) whatever the antibiotic susceptibility of the strain. These systematic isolation procedures were given up at the beginning of 2002 since the number of colonized-infected patients remained stable from 1998 to 2001.

Objective: The aim of this study was to evaluate the impact of this decision on the risk of Ab infection.

[Surveillance of antimicrobial resistance and antimicrobial use in a university-affiliated hospital: implementation of a computerized system].

Unlabelled: After half a century of antibiotic use, the increasing problem of the emergence and spread of antimicrobial-resistant pathogens has created a problem of public health. The causes of this problem are multifactorial, but the excessive and inappropriate use of antimicrobials is the principal cause. The current guidelines for the control of antimicrobial resistance in hospitals recommend the implementation of a surveillance system of antimicrobial use and antimicrobial resistance data.

Dynamics of HPV16 DNA load reflect the natural history of cervical HPV-associated lesions.

Background: High burden of high risk human papillomavirus (HR HPV) has been shown to be predictive for the development of high grade cervical lesions and invasive cancers. However, low viral load cannot inevitably exclude progression towards cervical diseases. Moreover, few studies addressed whether viral load could predict infection clearance.

Esophageal stents as a salvage therapy for non-malignant iatrogenic esophageal perforations.

Background: Esophageal non-malignant perforations are severe life-threatening conditions. The current treatment is either surgical or conservative.

Methods: We report a case series of 3 consecutive patients (1 female, 2 male; 34-68 years) treated with expandable covered stents for non-malignant iatrogenic esophageal perforations.

Use of intranasal mupirocin to prevent methicillin-resistant Staphylococcus aureus infection in intensive care units.

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) causes severe morbidity and mortality in intensive care units (ICUs) worldwide. The purpose of this study was to determine whether intranasal mupirocin prophylaxis is useful to prevent ICU-acquired infections with MRSA.

Materials And Methods: We conducted a 4-year observational retrospective study in a 15-bed adult medical ICU.

Estimation of the cumulative incidence of hospital-acquired bacteremia from prevalence data: a formula.

We evaluated the validity of the formula of Rhame and Sudderth to estimate the cumulative incidence of nosocomial bacteremia from prevalence studies. The observed cumulative incidence was threefold higher than the calculated cumulative incidence. We do not recommend converting prevalence into incidence data for nosocomial bloodstream infections.

[Regional surveillance of the evolution of methicillin resistant Staphylococcus aureus (MRSA): what results for what teaching?].

Objective: The aim of this study was to describe the evolution of MRSA within hospitals located in Franche-Comté from 1999 to 2003 and to establish the MRSA risk according to the type of hospitalization.

Methods: Surveillance of multidrug resistant bacteria was carried out according to the French national guidelines for the prevention of nosocomial infections.

Results: The global incidence of MRSA colonized/infected patients (screened by clinical samples) per 1000 patient-days had decreased from 0.

Relationship between ceftriaxone use and resistance to third-generation cephalosporins among clinical strains of Enterobacter cloacae.

Objective: To investigate the potential correlation between the use of extended-spectrum cephalosporins (ESCs) and resistance to this antibiotic class among clinical isolates of Enterobacter cloacae in a university-affiliated hospital.

Materials And Methods: Data on antimicrobial resistance and antimicrobial use concerning E. cloacae and ESCs were collected over a 4 year period.

Microbiological and epidemiological studies of Enterococcus faecium resistant to amoxycillin in a university hospital in eastern France.

Over 3 years, during six 1-month periods of surveillance, 69 cases of Enterococcus faecium colonisation or infection were detected in a university hospital in eastern France. Thirty-two cases involved strains resistant to amoxycillin (crude incidence of 0.21/1000 patient-days).

[E. coli: resistance to quinolones and beta-lactams of clinical strains isolated in the Franche-Comté region of France].

Aim Of The Study: Numerous European studies have reported an increase of resistance to quinolones among E. coli. We conducted a regional study to update our knowledge on this evolution.

[Prognosis and treatment of spontaneous intracerebral hematoma: review of the literature].

The natural history of spontaneous intracerebral hematomas is difficult to precisely ascertain because of the heterogeneous nature of published series. However, the early evolution of these hematomas, within the first 24 hours, is now well known, especially with regards to predictive factors for early deterioration. Prognosic factors of longer-term evolution include alteration in the level of consciousness, as determined by the Glasgow score, the volume of the intracerebral hematoma, and the presence of intraventricular rupture.