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Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé Objectifs de l’étude Les carcinomes épidermoïdes de la cavité buccale du sujet jeune constituent une entité spécifique dont la prise en charge et le pronostic sont discutés. Nous avons effectué une analyse rétrospective des dossiers de l’ensemble des patients âgés de moins de 40 ans et pris en charge à Gustave-Roussy pour un carcinome épidermoïde de la cavité buccale entre 1999 et 2011. Méthodes Les caractéristiques des patients, des tumeurs, du traitement, et le devenir ont été enregistrés. Une analyse de survie par la méthode de Kaplan-Meier a été réalisée, ainsi qu’une analyse unifactorielle et multifactorielle à la recherche de facteurs pronostiques de la survie globale et la survie sans progression. Résultats Soixante-trois patients ont été identifiés. Le suivi médian était de 64 mois. La majorité des tumeurs siégeait au niveau de la langue mobile ( n = 54, 86 %). Au total 17 patients sont décédés, dont 15 du cancer traité. Les taux de survie globale et sans progression à 5 ans étaient de 80 % et 69 %. Les taux de survie sans rechute locale, régionale ou métastatique à 5 ans étaient de 80 %, 91 % et 89 %. En analyse multifactorielle, seule l’absence de chirurgie initiale était pronostique pour la survie globale ( hazard ratio [HR] : 13,5 [2,0 ; 90,5], p = 0,007), tandis que la consommation d’alcool (HR : 0,38 [0,15 ; 0,9], p = 0,03) et l’absence de chirurgie (HR : 9,8 [1,9 ; 50,9], p = 0,006) étaient associées à une diminution de la probabilité de survie sans progression. Un âge plus jeune (moins de 30 ans) n’était pas associé ni à la survie globale ni à celle sans progression. Conclusion Les taux de survie et de contrôle tumoral sont relativement élevés chez les sujets jeunes atteints de carcinome épidermoïde de la cavité buccale traités dans un centre tertiaire. L’identification préthérapeutique des sujets à risque de récidive est actuellement difficile. La balance entre risque de rechute et toxicité des traitements justifie la réalisation d’études supplémentaires, sur le plan clinique et pour le développement de biomarqueurs pronostiques. Purpose Squamous cell carcinomas of the oral cavity occurring in young people represent a specific entity. Its management and prognosis are controversial. We performed a retrospective chart review of all patients aged less than 40 years old and treated at Gustave-Roussy Cancer Centre for a squamous cell carcinomas of the oral cavity between 1999 and 2011. Methods Patients and tumour characteristics, type of treatment and follow-up data were collected. Survival data were analysed according to the methods of Kaplan-Meier and both univariate and multivariate analyses were performed to look for prognostic factors regarding overall survival and progression-free survival. Results Sixty-three patients were identified. Median follow-up was 64 months. Most of the tumours were initially located in the mobile tongue ( n = 54, 85.7%). Overall 17 patients had died, including 15 from the treated cancer. Overall and progression-free survival rates at 5 years were respectively 79.6% and 68.6%. The corresponding 5 years local, regional and metastatic relapse free survival rates were 80%, 91% and 89% respectively. In the multivariate analysis only the absence of initial surgery (hazard ratio [HR]: 13.5 [2.0; 90.5]; P = 0.007) was prognostic for overall survival, while alcohol abuse (HR: 0.37 [0.15; 0.9]; P = 0.03) and the absence of surgery (HR: 13.6 [2.5; 74.2]; P = 0.002) were associated with a decreased progression-free survival. A younger age (less than 30 year old) was not associated with the risk of recurrence or death. Conclusion Survival rates and tumour control probabilities are relatively high among young patients suffering from squamous cell carcinomas of the oral cavity treated at a tertiary centre. The early identification of patients at risk of relapse is currently difficult. The balance between recurrence and treatment toxicity warrants further studies, both on the clinical level and for the development of prognostic biomarkers. [ABSTRACT FROM AUTHOR]

Copyright of EMC-Radiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Radiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectifs Les carcinomes épidermoïdes de la cavité buccale touchent habituellement les personnes âgées de plus 50 ans ayant eu une intoxication alcoolotabagique. Chez les patients de moins de 40 ans, ils sont rares et leur pronostic n’est pas connu. L’objectif est de déterminer le pronostic du carcinome épidermoïde de la cavité buccale chez les patients jeunes. Patients et méthodes Étude rétrospective, monocentrique de type cas-témoin. Les patients inclus étaient atteints d’un carcinome épidermoïde de la cavité buccale traité à l’institut Gustave-Roussy (IGR) de 1999 à 2012. Les patients avaient moins de 40 ans. Les témoins étaient âgés de plus de 40 ans. Deux témoins ont été sélectionnés pour chaque cas et appariés sur le sexe, le TNM et la période de traitement. Résultats Cinquante-sept patients, 44 hommes et 13 femmes ( sex ratio de 3,4) ainsi que 114 témoins ont été inclus. L’âge médian était de 32 [19–39] ans pour les cas contre 53 [41–61] ans pour les témoins ( p < 0,0001). Vingt-six (456 %) cas n’avaient jamais fumé contre 9 (7,8 %) témoins ( p < 0,0001), 47 (82,5 %) cas n’avaient pas consommé d’alcool contre 31 (27,2 %) témoins ( p < 0,0001). Cinquante-trois (93 %) cas et 104 (91,2 %) témoins avaient eu un traitement chirurgical ( p = 0,69), 29 (51 %) cas avaient reçu une radiothérapie ou une chimioradiothérapie contre 60 (52,6 %) témoins. Les taux de contrôle locorégional à 5 ans étaient de 75 % chez les patients et de 73 % chez les témoins, ceux de survie spécifique à 5 ans respectivement de 79 % et 77 %, ( p = 0,7), ceux de survie globale à 5 ans de 76 % et 64 % ( hazard ratio : 0,56 [0,3 ; 1,0] ; p = 0,05). Conclusion Le taux de survie globale à 5 ans des patients de moins de 40 ans atteints d’un carcinome épidermoïde de la cavité buccale tend à être meilleur que celui des patients plus âgés, alors que celui de survie spécifique est similaire. [ABSTRACT FROM AUTHOR]

Purpose: Squamous cell carcinomas of the oral cavity occurring in young people represent a specific entity. Its management and prognosis are controversial. We performed a retrospective chart review of all patients aged less than 40 years old and treated at Gustave-Roussy Cancer Centre for a squamous cell carcinomas of the oral cavity between 1999 and 2011., Methods: Patients and tumour characteristics, type of treatment and follow-up data were collected. Survival data were analysed according to the methods of Kaplan-Meier and both univariate and multivariate analyses were performed to look for prognostic factors regarding overall survival and progression-free survival., Results: Sixty-three patients were identified. Median follow-up was 64 months. Most of the tumours were initially located in the mobile tongue (n=54, 85.7%). Overall 17 patients had died, including 15 from the treated cancer. Overall and progression-free survival rates at 5 years were respectively 79.6% and 68.6%. The corresponding 5 years local, regional and metastatic relapse free survival rates were 80%, 91% and 89% respectively. In the multivariate analysis only the absence of initial surgery (hazard ratio [HR]: 13.5 [2.0; 90.5]; P=0.007) was prognostic for overall survival, while alcohol abuse (HR: 0.37 [0.15; 0.9]; P=0.03) and the absence of surgery (HR: 13.6 [2.5; 74.2]; P=0.002) were associated with a decreased progression-free survival. A younger age (less than 30 year old) was not associated with the risk of recurrence or death., Conclusion: Survival rates and tumour control probabilities are relatively high among young patients suffering from squamous cell carcinomas of the oral cavity treated at a tertiary centre. The early identification of patients at risk of relapse is currently difficult. The balance between recurrence and treatment toxicity warrants further studies, both on the clinical level and for the development of prognostic biomarkers., (Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Introduction: Acute exacerbations of chronic obstructive pulmonary disease (COPD) patients are major events in the history of this chronic respiratory disease. Their management in French emergency services is unknown, although national guidelines exist., Methods: This is a descriptive audit study, over a 10 weeks period (12/01-22/03/2009), of the management of COPD exacerbations in the RESUVal (Réseau des Urgences de la Vallée du Rhône, France) network emergency departments., Results: The enrollement of 16 emergency units allowed the analysis of 221 exacerbations of COPD. Measurement of respiratory rate and description of the sputum were mentioned in only 99 (45%) medical records. The rest of the initial assessment was generally satisfactory. Regarding the therapeutic management, 215 (97%) patients received oxygen, beta-2-agonist aerosols were administrated for 209 (95%) patients and anticholinergic aerosols were used for 176 (80%) patients. A systemic corticosteroid and antibiotics were respectively prescribed for 116 (52%) and 123 (56%) patients. Non-invasive ventilation (NIV) was used in only 59% of patients presenting a pH<7.35., Conclusions: These findings demonstrate that management of exacerbations of COPD could be improved through systematic patients' respiratory rate and sputum characteristics recording or NIV utilization reinforcement., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Restorative materials have different consequences on the periodontium. The surface of these materials may influence gingival health and cause in some instances gingival inflammation. The purpose of this study was to investigate and compare, in a healthy periodontium, intracrevicular plaque bacteria (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis and Treponema denticola), at day 0 and at 6 months, around subgingivally located amalgam, composite and compomer fillings. All the tests were negative (less than 0.1% of the sum of 103 cells), since none of the investigated pathogens were detected. It has been concluded that the material used does not have direct effect on the bacteria species developed around the restorations at this short time period.

Combined radical radiation therapy for head and neck carcinoma should be planned with intensity modulated beams to provide a rapid answer to patients' requirements in terms of quality of treatment. The most frequent late toxicity of radiation therapy is xerostomia, which may be prevented by using this technique able to significantly spare salivary glands irradiation. Selection of indications is a very important step. The objective of sparing salivary functions, strongly associated with optimization criteria of quality of life should be considered as a main objective in irradiation of head and neck tumours. The various possibilities offered by this technique allowing to boost a target volume included in prophylactically irradiated regions could offer the possibility to escalate the dose in selected patients. The feasibility of this process is currently validated in prospective studies. Finally, routine implementation of intensity modulated radiation therapy should be performed with strong and robust quality assurance procedures, ensuring that the expected benefit could be increased with the current developments by using rotational techniques., (Copyright © 2011 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)

Purpose: To compare screening breast MRI with conventional screening techniques in high-risk patients with genetic mutation., Materials and Methods: Prospective study of 85 patients (mean age of 43 years) with genetic mutation and screening > or = 2 years (mean of 2.7 years, 231 screening examinations). BI-RADS lesions 3-5 were biopsied; isolated BI-RADS 3 lesions on MRI were followed. Results from both techniques were compared. The number of short interval follow-up examinations and biopsy results were reviewed., Results: Eight cancers were diagnosed (3 in situ, 5 invasive carcinomas including an interval cancer, mean size of 14 mm). The sensitivity values for mammography, US and MRI were 12.5%, 50% and 95%, and specificity values were 98.7%, 97.3% and 94.8% respectively. Nineteen short interval follow-up MRI examinations were performed (19%): 14% of patients at initial screening and 5% and 6% at the the second and third screenings. Thirty-two biopsies were performed in 17 patients, including 18 after MRI (PPV of cytology: 30%, and biopsy: 58%)., Conclusion: Our results confirm the value of MRI for screening of high-risk patients with genetic mutation.

Background: The extent of smoking related health and economic problems is causing increasing alarm throughout the world. In the last few years a great number of subjects, especially in the developing world, have been smoking narghile and epidemiological studies on narghile smoking are an essential subject for investigation. The objectives of this study are to describe the social and cultural characteristics of narghile smokers in Lebanon compared to tobacco smokers., Materials and Methods: Our sample is based on the data of 37579 subjects who consulted a non-governmental organisation (NGO), the Hariri Foundation, between 2003 and 2005. This NGO comprises 22 specialised centres distributed throughout Lebanon. The following data concerning exclusive narghile and cigarette smokers were collected: age, sex, the type and duration of tobacco addiction and the level of education., Results: 13776 subjects (36.6% of the sample) were smokers of whom 88% smoked mostly cigarettes. 1529 subjects (11.1%) smoked narghile exclusively, a prevalence of 4.06%. The narghile smokers were younger than the cigarette smokers with a mean age of 36.2+/-8.63 years compared to 45.52+/-1.87 years. The majority of narghile smokers were women (56.57%) giving a male/female ratio of 0.77. A large number of narghile smokers were recent consumers with an exposure of less than 5 years. They differed from the cigarette smokers of whom the majority (72.2%) had smoked for more than 10 years. The proportion of illiterate subjects was greater among the narghile smokers (36.2%) than the cigarette smokers (24.2%)., Conclusion: The consumption of tobacco is a real and frequent problem in Lebanon. The consumption of narghile is scourge that is gaining popularity, notably among women and the young. This problem is becoming a public health issue that needs to be taken into account within the framework of an anti-smoking policy in Lebanon.

Objective: To evaluate elastography in the characterization of breast nodules., Material and Methods: Elastography (Hitachi, 7.5- to 13-MHz probe; Ueno classification, scores 1-3=benign, 4-5=malignant) was evaluated in 125 subclinical lesions in 114 patients. The results were compared to those of the ACR's BI-RADS sonography categories (benign=2 and 3, malignant=4 and 5) and to the results of the percutaneous samples taken and/or surgery (122 lesions evaluated, 59%<10 mm, 61 cancers, 61 benign lesions)., Results: There were three technical failures (2.4%). The elastography was in agreement with histology for 101 lesions, with 13 false-negative results and eight false-positive results (sensitivity, 78.7%; specificity, 86.9%; PPV, 85.7%; NPV, 80.3%); versus agreement with the BI-RADS classification for 98 lesions with one false-negative result and 23 false-positive results (sensitivity, 98.4%; specificity, 47.5%; PPV, 65.2%; NPV, 96.7%)., Conclusion: Elastography is a simple and rapid complementary method that can improve the specificity and the PPV of morphological imaging studies of breast nodules with a low level of suspicion (BI-RADS categories 3 and 4a), which should decrease the rate of unnecessary benign biopsies.

Objective: Evaluate the usefulness of MRI in local staging of Paget disease of the breast., Materials and Methods: Clinical, radiological (mammographies, MRI), and histological data were analyzed in six female patients presenting Paget disease of the breast. The criteria for analysis in MRI were the following: morphology of the aureola-nipple plaque (thickening, regularity of the contour) and the type of enhancement after injection of contrast medium (signal intensity/time curve), detection of abnormal enhancing in the mammary gland, and ganglion areas., Results: None of the patients presented a palpable mass or a suspicious anomaly on mammography. On MRI, the aureola-nipple plaque was morphologically abnormal in four cases, with suspicious enhancement in two cases (two cases of ductal carcinoma in situ) and normal enhancement in two cases (one case of ductal carcinoma in situ). In the two other cases, the aureola-nipple plaque was normal (one case of ductal carcinoma in situ). Distant abnormal enhancement of the aureola-nipple plaque was noted in two cases (one case of ductal carcinoma in situ and one benign lesion)., Conclusion: The MRI aspect of the aureola-nipple plaque in Paget disease shows little concordance with the histological results. MRI can be useful in detecting distant lesions when there is no clinical sign nor a suspicious mammography.

Since January 2000, sentinel lymph node detection is routinely performed at the Institut Curie, involving a multidisciplinary team of trained surgeons, nuclear medicine physicians, radiologists and pathologists. During a three-year period, 738 patients undergoing tumorectomy with conservative surgical treatment of the breast were included in the sentinel node procedure consisting of systematic pre-operative tumor biopsies, peritumoral lymph tracer injections at tumor contact (radionuclide/blue dye), primary surgical removal of the first sentinel lymph node, frozen section diagnosis, followed by a standardized pathological analysis, and finally the application of precise criteria to determine whether further surgery is necessary. This article is an evaluation of the sentinel lymph node technique in a specialized Center providing a breakdown of the strong points and weak points of the procedure., (Copyright John Libbey Eurotext 2003.)

In 2004, breast cancer screening will be effective in France. This evolution has a strong impact on our mammographic practice that becomes a real mission of public health. Digital mammography, compared to screen-film mammography, provides the same results for the detection of breast cancer, computer-aided detection systems represent the most relevant application of this technology at this time. The setting up of a quality control will allow the introduction of this technology in screening during 2004. Percutaneous imaging-guided procedures are now currently used for the diagnosis of nonpalpable breast lesions and allow the selection of patients for surgery. These procedures have emphasized the need for a multidisciplinary approach of the patients. Indications of MRI have not changed because of its moderated specificity and no relevant development of interventional-guided procedures. Work on standardization of radiological reports and assessment categories goes on. This classification is already applied for mammography, and new classifications for lesions detected by ultrasound or MRI will be published by the American College of Radiology (Breast Imaging Reporting and Data System, 4th edition, available in 2003).

The increasing number of nonpalpable breast lesions found at screening mammography has induced the development of percutaneous imaging-guided procedures to reduce the number of surgical biopsies. After a description of the indications (classification of the American College of Radiology), the different types of sampling procedures (fine needle aspiration, core and large-core biopsies) will be described and the material used also. Depending on the type of breast lesions (mass, clustered microcalcifications), ultrasound--guided and stereotactic--guided biopsies will be explained. Clear information to the patients, efficient quality control and multidisciplinary approach are mandatory for the success of these percutaneous diagnostic procedures.