237 results match your criteria: "groupement hospitalier Sud[Affiliation]"

Excessive inflammatory response has been implicated in severe respiratory forms of coronavirus disease 2019 (COVID-19). Trace elements such as zinc, selenium, and copper are known to modulate inflammation and immunity. This study aimed to assess the relationships between antioxidant vitamins and mineral trace elements levels as well as COVID-19 severity in older adults hospitalized.

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Importance: Optimal transfusion strategies in traumatic hemorrhage are unknown. Reports suggest a beneficial effect of 4-factor prothrombin complex concentrate (4F-PCC) on blood product consumption.

Objective: To investigate the efficacy and safety of 4F-PCC administration in patients at risk of massive transfusion.

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Purpose: Clinical pharmacy can reduce drug-related iatrogenesis by improving the management of adverse effects of drugs, limiting drug-drug interactions, and improving patient adherence. Given the vulnerability of cancer patients and the toxicity of injectable anticancer drugs, clinical pharmacy service (CPS) could provide a significant clinical benefit in cancer care. This review aims to synthesize existing evidence on clinical pharmacy's impact on patients treated with intravenous anticancer drugs.

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[Differential diagnostic between hepatocellular carcinoma and hepatoid carcinoma with bone metastasis revelation: What tools can be used?].

Ann Pathol

September 2023

Institut de pathologie multisite, centre de biologie et de pathologie Est, groupement hospitalier Est, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France. Electronic address:

Bone metastases of hepatocellular carcinoma (HCC) are rare and disease-revealing bone metastasis are exceptional. Here, we report the case of a 69-year-old man with a cervical vertebral metastasis of hepatocellular carcinoma. Morphological aspect of a metastatic tumor with eosinophilic and polygonal cells raises the question of the differential diagnosis between a localization of a hepatocellular carcinoma or an hepatoid carcinoma, notably when the metastasis is the first clinical manifestation.

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Impact of pharmaceutical care interventions on multidisciplinary care of older patients with cancer: A systematic review.

J Geriatr Oncol

May 2023

Department of Pharmacy, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite Cedex 69495, France; Université Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Cancérologie de Lyon, Lyon, Oullins cedex F-69921, France.

Introduction: Optimizing medication use is a major issue in older patients with cancer and pharmacists are increasingly involved in their multidisciplinary care. The implementation of pharmaceutical care interventions must be supported by impact evaluations to enable their development and funding. This systematic review aims to synthesize evidence on the impact of pharmaceutical care interventions in older patients with cancer.

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Purpose: Vancomycin dosing remains challenging in patients receiving intermittent hemodialysis, especially in developing countries, where access to therapeutic drug monitoring and model-based dose adjustment services is limited. The objectives of this study were to describe vancomycin population PK in patients receiving hemodialysis in a Malian and French center and examine the optimal loading dose of vancomycin in this setting.

Methods: Population pharmacokinetic analysis was conducted using Pmetrics in 31 Malian and 27 French hemodialysis patients, having a total of 309 vancomycin plasma concentrations.

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Purpose: Increasing evidence supports daptomycin therapeutic drug monitoring. The author's reference center used to perform therapeutic drug monitoring in patients who receive high-dose daptomycin for bone and joint infections, with a three-sample strategy to estimate the daptomycin daily area under the concentration-time curve (AUC). The objective of this study was to evaluate simpler strategies based on only 2 or 1 sample(s).

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H syndrome mimicking Erdheim Chester disease: new entity and therapeutic perspectives.

Haematologica

August 2023

Department of Internal Medicine, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard-Lyon1, Lyon, France; Pôle IMER, Lyon, France; HESPER EA 7425, Lyon.

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Article Synopsis
  • A study was conducted in 8 French ICUs to investigate how immunosuppression affects the acquisition of multidrug-resistant (MDR) bacteria and infections in critically ill patients staying over 48 hours.
  • Out of 750 patients involved, 35.2% were immunocompromised, and surprisingly, these patients exhibited a lower incidence of MDR colonization and infections compared to their non-immunocompromised counterparts.
  • Results suggest that contact precautions and isolation measures play a crucial role in preventing the spread of MDR bacteria in ICUs, highlighting potential implications for antibiotic use and management practices.
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Publication bias may lead to a misestimation in the association between pharmacogenetic biomarkers (PGx) and antiseizure drug's adverse effects (AEs). We aimed to assess its prevalence in this field. We searched for systematic reviews assessing PGx of antiseizure drug's AEs.

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Purpose: Chondrosarcomas (CHSs), which represent 20% of primary bone tumors in adults, are mostly resistant to radio- and chemotherapy. It is therefore essential that new therapeutic approaches, targeted to the tumour, be developed to improve the prognosis of patients. The effectiveness, as a radiosensitizing agent, of gadolinium oxide nanoparticles (GdoNP, AGuIX) nanoparticles in CHS was evaluated in vitro, in spheroid CHS models allowing to reproduce cell-cell extracellular matrix interactions, and, in vivo, in a nude mouse model with heterotopic tumour xenograft.

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Article Synopsis
  • Chromoanagenesis is a cellular process causing complex chromosomal rearrangements during a significant event, potentially leading to genetic material loss or gain and various traits, typically occurring sporadically but can also be inherited.
  • In a study involving six families, researchers investigated how asymptomatic parents passed on these rearrangements to their children, using karyotyping, fluorescent in situ hybridization, chromosomal microarray, and whole genome sequencing to analyze the chromosomal changes.
  • The findings suggest that chromoanagenesis can occur without affecting the parent's health or fertility, and prenatal testing using chromosomal microarray is recommended to identify any genetic imbalances in offspring from these families.
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Background: Treating pneumonia in old patients remains challenging for clinicians. Moreover, bacterial antimicrobial resistance is a major public health threat.

Objective: The PROPAGE study evaluated the interest of a strategy using serial measurements of procalcitonin (PCT) to reduce the duration of antibiotic therapy in old patients with pneumonia.

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Article Synopsis
  • A multicenter study examined the impact of the COVID-19 pandemic on antifungal use in hospitals, noting a potential overuse similar to the trend seen with antibacterials.
  • The study found a significant increase in the consumption of antifungals like voriconazole and caspofungin during 2020 compared to 2019, correlating with higher rates of invasive fungal diseases in both COVID-19 and non-COVID-19 patients.
  • The findings highlight the need for effective antifungal stewardship strategies to manage and control antifungal consumption amidst rising fungal infections during the pandemic.
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Background: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious complication in the ICU that results in increased mortality and risk of chronic kidney disease (CKD). Some studies suggest RRT modality may have an impact on long-term renal recovery after AKI. However, other predictive factors of severe long-term CKD in ICU patients with AKI requiring RRT are unknown.

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Suboptimal exposure to fluconazole in critically ill patients: Pharmacokinetic analysis and determinants.

Infect Dis Now

March 2023

Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France; Univ Lyon, Université Lyon 1, ISPB, Faculté de Pharmacie de Lyon, Lyon, France; Univ Lyon, Université Lyon 1 UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France.

Objectives: This study aims at evaluating fluconazole exposure in critically ill patients and identifying variables associated with the latter.

Patients And Methods: This was a 2-year (2018-2019) retrospective multicenter cohort study. Adult patients > 18 years-old with at least one fluconazole concentration measurement during their ICU stay were included.

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Nutritional status is an important protection factor against viral infections. Both undernutrition and malnutrition cause deficits in micronutrients, trace elements and vitamins necessary for various physiological functions and the appropriate functioning of the immune system. These deficiencies and infectious diseases often coexist, with complex interactions.

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[Rosai-Dorfman-Destombes disease with a misleading laryngeal presentation].

Ann Pathol

November 2022

Service d'anatomie et cytologie pathologiques, institut de pathologie multisite, groupement hospitalier Sud, hospices civils de Lyon, Pierre-Bénite, France.

Rosai-Dorfman-Destombes disease is a rare non-Langerhansian cell histiocytosis characterized by the accumulation of large activated histiocytes in the affected tissues with images of emperipolesis. The diagnosis is not really problematic in the classical forms, with a lymph node presentation, whose histology is very suggestive. However, it can be much more difficult in the extra-nodal forms, which are misleading in both their clinical and histological presentation.

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Therapeutic drug monitoring (TDM) of tobramycin is widely performed in patients with cystic fibrosis (CF), but little is known about the value of model-informed precision dosing (MIPD) in this setting. We aim at reporting our experience with tobramycin MIPD in adult patients with CF. We analyzed data from adult patients with CF who received IV tobramycin and had model-guided TDM during the first year of implementation of MIPD.

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[Place of internal medicine specialists in inpatient unprogrammed care of adult patients in France: A survey of in training and senior internal medicine specialists].

Rev Med Interne

September 2022

Service de médecine interne, hôpital Jean-Verdier, Assistance-Publique Hôpitaux-de-Paris, Bondy, France.

Introduction: French internal medicine specialists are trained in clinical immunology and rare diseases as well as frequent ones. The latest activity is rarely highlighted by practitioners themselves and their representative authorities. Frequent diseases care in French hospitals are also the tasks of physicians without internal medicine specialty, mostly trained in general medicine, who practice in departments carrying various names.

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Introduction: Oral folic acid supplementation is essential for patients treated with pemetrexed, to prevent the risk of severe hematologic toxicity. In case of intestinal absorption disorder, no recommendations exist for intravenous folic acid supplementation.

Case Report: We describe a 74-year-old patient with multimetastatic non-small-cell lung adenocarcinoma, receiving first-line chemotherapy with carboplatin AUC5, pemetrexed 500 mg/m and pembrolizumab 200 mg intravenously every 3 weeks.

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Osteocutaneous flap (OCF) mandible reconstruction is at high risk for surgical site infection. This study aimed to describe diagnosis, management, and outcome of OCF-related osteomyelitis. All patients managed at our institution for an OCF-related osteomyelitis following mandible reconstruction were included in a retrospective cohort study (2012-2019).

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Percutaneous osteosynthesis for the treatment of traumatic odontoid fractures in elderly patients.

Diagn Interv Imaging

July 2022

Department of Interventional Radiology, Saint-Etienne University Hospital, 42055 Saint-Etienne, France; CREATIS Université Lyon 1, CREATIS-LRMN, CNRS/UMR/5220-INSERM U630, 69100 Villeurbanne, France. Electronic address:

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Background: This study assessed the risk of reduced disease-free survival (DFS) and poor clinical outcome in patients with papillary thyroid carcinomas (PTC) with microscopic extra-thyroidal extension (mETE), as compared to PTC patients without mETE. Methods: Retrospective analysis of a prospective database of patients treated by total thyroidectomy and radioactive iodine (RAI) with a five-year follow-up and tumors < 40 mm. In total, 303 patients were analyzed: 30.

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