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1. Sight-threatening Graves’ orbitopathy: Twenty years’ experience of a multidisciplinary thyroid-eye outpatient clinic

Author

Blandine Tramunt, Solange Grunenwald, Philippe Imbert, Philippe Caron, Franck Boutault, Clinique Capio La Croix du Sud (FRANCE), Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE), and Capio Clinique du Parc

Subjects
Punctal plug, Male, Visual acuity, genetic structures, Endocrinology, Diabetes and Metabolism, Visual Acuity, Sight-threatening Graves’ orbitopathy, Ambulatory Care Facilities, Dysthyroid optic neuropathy, Optic neuropathy, Cornea, 0302 clinical medicine, Endocrinology, Optic Nerve Diseases, Outpatient clinic, education.field_of_study, Disease Management, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, Decompression, Surgical, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Endocrinologie et métabolisme, Tarsorrhaphy, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, medicine.symptom, Adult, medicine.medical_specialty, Population, 030209 endocrinology & metabolism, Context (language use), 03 medical and health sciences, Internal medicine, medicine, Humans, education, Corneal Ulcer, Glucocorticoids, business.industry, corneal ulcer, medicine.disease, eye diseases, Surgery, Ingénierie biomédicale, Graves Ophthalmopathy, Orbital decompression, sense organs, business
Abstract

International audience; CONTEXT:Sight-threatening Graves' orbitopathy affects 3% to 5% of patients with Graves' orbitopathy.OBJECTIVES:To describe the management of patients with sight-threatening Graves' orbitopathy seen in a multidisciplinary thyroid-eye outpatient clinic dedicated to Graves' orbitopathy (GO).PATIENTS AND METHODS:We enrolled all patients with sight-threatening GO (dysthyroid optic neuropathy and corneal ulcer as defined in the EUGOGO statement) seen and treated in our GO multidisciplinary thyroid-eye outpatient clinic over the last two decades.RESULTS:A total of 31 patients (median age 51 years old) including 24 women (77%) and 58% active smokers. This population represented 47 cases (case = eye) of sight-threatening GO. Dysthyroid optic neuropathy (DON) occurred in 40 eyes, corneal ulcer in 15 eyes and both in 8. At presentation, the clinical features of DON were reduced visual acuity (85%), visual field defects (80%), optic disc swelling (42%) and reduced colour vision (100%). At one year, surgical orbital decompression (OD) was performed in 82.5% of DON cases. Only seven eyes with DON were treated with pulses of intra-venous glucocorticoids. For 10 patients, several therapeutic strategies (OD n = 4, punctal plug n = 1, amniotic membrane graft n = 2, tarsorrhaphy n = 2, botulinum toxin injection = 3 and eyelid surgery n = 2) were used to treat corneal ulcer. For each ophthalmological parameter, more than 85% of DON cases had recovery or improvement after treatment. For visual acuity in corneal ulcer, it was 71.4%.CONCLUSION:We report 47 cases of sight-threatening GO. Orbital decompression was performed in the majority of DON cases and several therapeutic strategies were necessary to treat corneal ulcer. The results are satisfactory in sight-threatening Graves' orbitopathy due to multidisciplinary management.

Published
2019
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2. Cancer screening in France: subjects' and physicians' attitudes

Author

Yvan Coscas, Xavier Pivot, Jean-François Morère, Daniel Serin, Claire Roussel, Anne Calazel-Benque, Sylvie Dolbeault, Jean-Yves Blay, Moïse Namer, Laurent Cals, Olivier Rixe, François Eisinger, Cancérologie (Inserm U599/IPC), Université de la Méditerranée - Aix-Marseille 2-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Capio Clinique du Parc, Hopital Font-Pre, Clinique de la Porte de St Cloud, Conception synthèse et étude d'antitumoraux, Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), Institut Sainte Catherine [Avignon], ROCHE SAS, Roche SAS, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC)

Subjects
Male, Cancer Research, Health Behavior, Mass-screening, 0302 clinical medicine, Neoplasms, Surveys and Questionnaires, Epidemiology, Cancer screening, Mass Screening, MESH: Neoplasms, 030212 general & internal medicine, Practice Patterns, Physicians', MESH: Aged, education.field_of_study, MESH: Middle Aged, medicine.diagnostic_test, Brief Report, Physicians, Family, MESH: Physician's Role, Middle Aged, MESH: Patient Compliance, 3. Good health, Prostate cancer screening, Oncology, 030220 oncology & carcinogenesis, Health care opinion poll, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, France, Compliance, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, MESH: Physicians, Family, MESH: Attitude of Health Personnel, MESH: Health Behavior, education, Population, Sampling Studies, 03 medical and health sciences, MESH: Sampling Studies, medicine, Health services research, Humans, Mammography, MESH: Mass Screening, Physician's Role, MESH: Physician's Practice Patterns, Mass screening, Aged, MESH: Humans, business.industry, MESH: Questionnaires, Cancer, MESH: Adult, medicine.disease, MESH: Male, MESH: France, Health services misuse, Family medicine, Patient Compliance, business, MESH: Female, Lung cancer screening
Abstract

International audience; OBJECTIVE: Since screening for cancer has been advocated, funded, and promoted in France, it is important to evaluate the attitudes of subjects in the general population and general practitioners (GPs) toward cancer screening strategies. METHODS: EDIFICE is a nationwide opinion poll that was carried out by telephone among a representative sample of 1,504 subjects living in France and aged between 40 and 75 years and among a representative sample of 600 GPs. The questionnaire administered to subjects queried about previous screening for cancer. RESULTS: Ninety-three percent of women stated that they had undergone at least one mammography. Although rated "A" recommendation-strongly recommended-by the US Preventive Services Task Force, screening for colorectal cancer received less attention than prostate cancer screening which is rated "I"-insufficient evidence-(reported screening rates of 25% and 36%, respectively). Six percent of subjects stated that they had undergone lung cancer screening. GPs' attitudes toward cancer screening showed similar inconsistencies. CONCLUSIONS: It thus appears that understanding of cancer screening practices in the French general population does not match scientific evidence. To a lesser extent, this also holds for GPs.

Published
2008
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3. Impact of organised programs on colorectal cancer screening

Author

Sylvie Dolbeault, Claire Roussel, Anne Calazel-Benque, Jean-François Morère, Xavier Pivot, Daniel Serin, Olivier Rixe, Jean-Yves Blay, Laurent Cals, Yvan Coscas, François Eisinger, Moïse Namer, Cancérologie (Inserm U599/IPC), Université de la Méditerranée - Aix-Marseille 2-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Font-Pre, Capio Clinique du Parc, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Clinique de la Porte de St Cloud, Conception synthèse et étude d'antitumoraux, Institut Curie [Paris]-Centre National de la Recherche Scientifique (CNRS), Centre Azureen de cancérologie, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Sainte Catherine [Avignon], ROCHE SAS, Roche SAS, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), The EDIFICE committee, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Saas, Philippe, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC)

Subjects
Male, Cancer Research, Colorectal cancer, MESH: Logistic Models, MESH: Health Care Surveys, Logistic regression, 0302 clinical medicine, Mass Screening, Practice Patterns, Physicians', MESH: Aged, education.field_of_study, MESH: Middle Aged, Physicians, Family, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Oncology, Colorectal cancer screening, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, 030211 gastroenterology & hepatology, France, Colorectal Neoplasms, Attitude to Health, Research Article, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, MESH: Physicians, Family, MESH: Attitude of Health Personnel, Population, MESH: Attitude to Health, MEDLINE, lcsh:RC254-282, 03 medical and health sciences, Genetics, medicine, Humans, MESH: Mass Screening, MESH: Physician's Practice Patterns, education, Mass screening, Aged, Gynecology, MESH: Humans, business.industry, Odds ratio, medicine.disease, MESH: Male, MESH: France, Logistic Models, Health Care Surveys, Family medicine, Observational study, business, MESH: Female, MESH: Colorectal Neoplasms
Abstract

Purpose Colorectal cancer (CRC) screening has been shown to decrease CRC mortality. Organised mass screening programs are being implemented in France. Its perception in the general population and by general practitioners is not well known. Methods Two nationwide observational telephone surveys were conducted in early 2005. First among a representative sample of subjects living in France and aged between 50 and 74 years that covered both geographical departments with and without implemented screening services. Second among General Practionners (Gps). Descriptive and multiple logistic regression was carried out. Results Twenty-five percent of the persons(N = 1509) reported having undergone at least one CRC screening, 18% of the 600 interviewed GPs reported recommending a screening test for CRC systematically to their patients aged 50–74 years. The odds ratio (OR) of having undergone a screening test using FOBT was 3.91 (95% CI: 2.49–6.16) for those living in organised departments (referent group living in departments without organised screening), almost twice as high as impact educational level (OR = 2.03; 95% CI: 1.19–3.47). Conclusion CRC screening is improved in geographical departments where it is organised by health authorities. In France, an organised screening programs decrease inequalities for CRC screening.

Published
2008
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