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11 results on '"MESH : Epidemiologic Methods"'

1. HLA-B27 positive patients differ from HLA-B27 negative patients in clinical presentation and imaging: results from the DESIR cohort of patients with recent onset axial spondyloarthritis

Author

Chung, Ho Yin, Machado, Pedro, Van Der Heijde, Désirée, D'Agostino, Maria-Antonietta, Dougados, Maxime, Saraux, Alain, Department of Rheumatology, University Hospital Maastricht, Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Ambroise Paré, Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [AP-HP], Université de Brest (UBO) - IFR148, and Université de Brest (UBO) - Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Settore MED/16 - REUMATOLOGIA, Delayed Diagnosis, Spondyloarthropathy, [SDV]Life Sciences [q-bio], MESH : Sacroiliac Joint, MESH: Epidemiologic Methods, Gastroenterology, Severity of Illness Index, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, MESH : Back Pain, Back pain, Immunology and Allergy, MESH : Female, 030212 general & internal medicine, Age of Onset, MESH: Sacroiliac Joint, Axis, Cervical Vertebra, HLA-B27 Antigen, Sacroiliac joint, MESH : Prognosis, MESH: Middle Aged, MESH : Spondylarthritis, MESH : Adult, Middle Aged, Prognosis, Magnetic Resonance Imaging, 3. Good health, MESH : Age of Onset, [SDV] Life Sciences [q-bio], MESH : Phenotype, Cervical Vertebra, medicine.anatomical_structure, Phenotype, MESH: Young Adult, MESH : Severity of Illness Index, Female, medicine.symptom, Axis, musculoskeletal diseases, Adult, medicine.medical_specialty, MESH : Male, MESH: Age of Onset, MESH: Spondylarthritis, Immunology, MESH : Delayed Diagnosis, MESH : HLA-B27 Antigen, MESH : Young Adult, MESH: Phenotype, General Biochemistry, Genetics and Molecular Biology, MESH : Epidemiologic Methods, MESH: Prognosis, 03 medical and health sciences, Young Adult, Rheumatology, Internal medicine, MESH : Magnetic Resonance Imaging, MESH: Severity of Illness Index, Spondylarthritis, medicine, MESH : Sacroiliitis, Humans, MESH : Middle Aged, Sacroiliitis, MESH: Sacroiliitis, 030203 arthritis & rheumatology, Ankylosing spondylitis, HLA-B27, MESH: Humans, MESH : Axis, business.industry, MESH : Humans, MESH: Biological Markers, MESH: Adult, Sacroiliac Joint, medicine.disease, MESH: Male, Surgery, MESH : Biological Markers, MESH: Delayed Diagnosis, Back Pain, MESH: Back Pain, Age of onset, business, MESH: HLA-B27 Antigen, Epidemiologic Methods, MESH: Female, Biomarkers, MESH: Axis
Abstract

International audience; OBJECTIVE: To clarify the influence of human leucocyte antigen B27 (HLA-B27) status on the phenotype of early axial spondyloarthritis (SpA). METHODS: 708 patients with inflammatory back pain (IBP) defined by Calin or Berlin criteria were recruited; 654 fulfilled at least one of the SpA criteria (modified New York, European Spondyloarthropathy Study Group, Amor or Assessment of SpondyloArthritis international Society classification criteria for axial SpA) and were included in the analyses. Clinical, demographic and imaging parameters were compared between HLA-B27 positive and negative groups. Significant parameters in univariate differences between HLA-B27 positive and negative groups were retested in multivariate models explaining various outcomes. RESULTS: Patients had a short duration of axial symptoms (mean 1.5 years) and HLA-B27 was present in 61.5%. In multivariate analysis, HLA-B27 positivity was associated with a younger age at onset of IBP (regression coefficient (B)=(-2.60), p

Published
2011
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2. Drug-specific risk of non-tuberculosis opportunistic infections in patients receiving anti-TNF therapy reported to the 3-year prospective French RATIO registry

Author

D, Salmon-Ceron, F, Tubach, O, Lortholary, O, Chosidow, S, Bretagne, N, Nicolas, E, Cuillerier, B, Fautrel, C, Michelet, J, Morel, X, Puéchal, D, Wendling, M, Lemann, P, Ravaud, X, Mariette, Stéphane, Bretagne, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Service de Dermatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Service de Rhumatologie [CH Le Mans], Centre Hospitalier Le Mans (CH Le Mans), Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), RATIO group, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri-Mondor, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service de rhumatologie [CHU Pitié Salpêtrière] ( GRC-08 EEMOIS ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP), Service des maladies infectieuses et réanimation médicale, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou, Centre Hospitalier du Mans, Hôpital Jean Minjoz, Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Épidémiologie et Évaluation des Maladies Ostéoarticulaires Inflammatoires et Systémiques (GRC-08 EEMOIS), Service des maladies infectieuses et réanimation médicale [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou

Subjects
Male, MESH: Antirheumatic Agents, Opportunistic infection, Anti-Inflammatory Agents, MESH : Aged, MESH: Epidemiologic Methods, Receptors, Tumor Necrosis Factor, Etanercept, MESH: Antibodies, Monoclonal, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pneumocystosis, Immunology and Allergy, MESH : Female, 030212 general & internal medicine, MESH : Tumor Necrosis Factor-alpha, MESH: Aged, MESH: Immunoglobulin G, MESH: Middle Aged, MESH: Immunologic Factors, Antibodies, Monoclonal, Middle Aged, MESH : Adult, MESH : Antirheumatic Agents, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Antirheumatic Agents, Rheumatoid arthritis, MESH : Antibodies, Monoclonal, Female, France, medicine.drug, Adult, medicine.medical_specialty, MESH : Immunoglobulin G, MESH : Male, Immunology, Opportunistic Infections, MESH : Anti-Inflammatory Agents, Antibodies, Monoclonal, Humanized, MESH : Immunologic Factors, General Biochemistry, Genetics and Molecular Biology, MESH : Antibodies, Monoclonal, Humanized, MESH : Epidemiologic Methods, 03 medical and health sciences, Rheumatology, Psoriasis, Internal medicine, medicine, Adalimumab, Humans, Immunologic Factors, MESH : Middle Aged, Risk factor, MESH : France, Aged, 030203 arthritis & rheumatology, MESH: Humans, Tumor Necrosis Factor-alpha, business.industry, MESH : Humans, MESH : Opportunistic Infections, MESH: Adult, MESH: Opportunistic Infections, medicine.disease, MESH: Receptors, Tumor Necrosis Factor, Infliximab, MESH : Receptors, Tumor Necrosis Factor, MESH: Male, MESH: France, MESH: Antibodies, Monoclonal, Humanized, Immunoglobulin G, MESH: Tumor Necrosis Factor-alpha, MESH: Anti-Inflammatory Agents, Epidemiologic Methods, business, MESH: Female
Abstract

BackgroundAnti-tumour necrosis factor (TNF) therapy may be associated with opportunistic infections (OIs).ObjectiveTo describe the spectrum of non-tuberculosis OIs associated with anti-TNF therapy and identify their risk factors.MethodsA 3-year national French registry (RATIO) collected all cases of OI in patients receiving anti-TNF treatment for any indication in France. A case–control study was performed with three controls treated with anti-TNF agents per case, matched for gender and underlying inflammatory disease.Results45 cases were collected of non-TB OIs in 43 patients receiving infliximab (n=29), adalimumab (n=10) or etanercept (n=4) for rheumatoid arthritis (n=26), spondyloarthritides (n=3), inflammatory colitis (n=8), psoriasis (n=1) or other conditions (n=5). One-third (33%) of OIs were bacterial (4 listeriosis, 4 nocardiosis, 4 atypical mycobacteriosis, 3 non-typhoid salmonellosis), 40% were viral (8 severe herpes zoster, 3 varicella, 3 extensive herpes simplex, 4 disseminated cytomegalovirus infections), 22% were fungal (5 pneumocystosis, 3 invasive aspergillosis, 2 cryptococcosis) and 4% were parasitic (2 leishmaniasis). Ten patients (23%) required admission to the intensive care unit, and four patients (9%) died. Risk factors for OIs were treatment with infliximab (OR=17.6 (95% CI 4.3 - 72.9); p10 mg/day or intravenous boluses during the previous year (OR=6.3 (2.0 to 20.0); p=0.002).ConclusionVarious and severe OIs, especially those with intracellular micro-organisms, may develop in patients receiving anti-TNF treatment. Monoclonal anti-TNF antibody rather than soluble TNF receptor therapy and steroid use >10 mg/day are independently associated with OI.

Published
2011
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3. Return home at the end of life: Patients' vulnerability and risk factors

Author

P Le Coz, Y Matillon, François Chapuis, Christian Hervé, P Vassal, Service de soins palliatifs, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Laboratoire d'éthique médicale et médecine légale (LEM), Université Paris Descartes - Paris 5 (UPD5), Espace éthique méditerranéen, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Santé Individu Société (SIS), Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Méthodologie en Recherche Clinique, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Hôpital Bellevue, Santé Individu Société - SIS (SIS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université Lumière - Lyon 2 (UL2), Duchange, Nathalie, Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'éthique médicale et médecine légale ( LEM ), Université Paris Descartes - Paris 5 ( UPD5 ), Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Santé Individu Société - SIS ( SIS ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Hospices Civils de Lyon ( HCL ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon III ( UJML ) -Université Lumière - Lyon 2 ( UL2 ), Université Claude Bernard Lyon 1 ( UCBL ), and Université de Lyon-Université de Lyon-Hospices Civils de Lyon ( HCL )

Subjects
Gerontology, Male, Palliative care, MESH : Caregivers, Vulnerability, MESH : Aged, MESH: Delivery of Health Care, MESH: Epidemiologic Methods, MESH : Attitude to Death, MESH : Patient Preference, 0302 clinical medicine, MESH: Aged, 80 and over, Residence Characteristics, Risk Factors, MESH: Risk Factors, Epidemiology, Western world, MESH : Female, MESH: Residence Characteristics, MESH : Palliative Care, MESH: Terminally Ill, media_common, MESH: Patient Preference, Aged, 80 and over, MESH: Aged, Terminal Care, MESH: Middle Aged, Palliative Care, Patient Preference, General Medicine, MESH: Caregivers, MESH : Adult, Middle Aged, MESH : Risk Factors, Home Care Services, 3. Good health, MESH: Terminal Care, Caregivers, 030220 oncology & carcinogenesis, MESH : Residence Characteristics, [ SDV.ETH ] Life Sciences [q-bio]/Ethics, Female, MESH: Palliative Care, France, 0305 other medical science, End-of-life care, Autonomy, Adult, medicine.medical_specialty, Attitude to Death, Adolescent, media_common.quotation_subject, MESH : Male, MESH : Terminal Care, MESH: Home Care Services, Context (language use), Vulnerable Populations, MESH : Epidemiologic Methods, MESH : Terminally Ill, 03 medical and health sciences, 030502 gerontology, MESH: Attitude to Death, MESH : Adolescent, medicine, MESH : Vulnerable Populations, Humans, Terminally Ill, MESH : Middle Aged, Family, MESH : France, MESH : Aged, 80 and over, MESH: Family, Aged, MESH : Delivery of Health Care, MESH: Adolescent, MESH: Humans, business.industry, MESH : Home Care Services, MESH : Humans, MESH: Adult, [SDV.ETH] Life Sciences [q-bio]/Ethics, MESH: Male, MESH: Vulnerable Populations, [SDV.ETH]Life Sciences [q-bio]/Ethics, MESH: France, Anesthesiology and Pain Medicine, Observational study, MESH : Family, business, Epidemiologic Methods, Delivery of Health Care, MESH: Female
Abstract

International audience; Although most of the people in good health questioned about the subject said they would like to die at home, in the western world between 60 and 80% of deaths occur in hospital. Most authors consider that the indispensable conditions for a return home are the patient's desire and presence of the family and caregivers with the appropriate skills. The assessment of other factors predictive of a return home is inadequate. The aim of this study is to clarify how the return home is influenced by the vulnerability of the patient at the end of life, and by that of the family and caregivers. We carried out a multicentric, observational, prospective, exhaustive and longitudinal epidemiological study (three months follow-up), including 146 patients hospitalized at the end of their life and desiring to return home. For these patients the caregivers respected their freedom to choose to die at home in over half the cases (56%). Their overall vulnerability (personal, family context and caregivers) had a significant influence on the return home. This overall vulnerability was in fact identified as applying in 40% of the clinical situations, and made the possibility of a return home 50% less likely.

Published
2011
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4. Allogeneic haematopoietic stem cell transplantation for myelofibrosis: a report of the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

Author

Robin, Marie, Tabrizi, Reza, Mohty, Mohamad, Furst, Sabine, Michallet, Mauricette, Bay, Jacques-Olivier, Cahn, Jean-Yves, De Coninck, Eric, Dhedin, Nathalie, Bernard, Marc, Rio, Bernard, Buzyn, Agnès, Huynh, Anne, Bilger, Karin, Bordigoni, Pierre, Contentin, Nathalie, Porcher, Raphaël, Socié, Gérard, Milpied, Noel, Service d'hématologie greffe [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1-CHU Bordeaux [Bordeaux], Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'hématologie [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Unité de transplantation médullaire et laboratoire d'oncologie moléculaire, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER-UNICANCER, TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Hematology, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, Laboratoire Hubert Curien [Saint Etienne] (LHC), Institut d'Optique Graduate School (IOGS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Département d'Hématologie et Oncologie Médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Unité de Transplantation Médullaire, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Hôpital d'enfants, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Haematology, CHU Bordeaux [Bordeaux], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ) -Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers, Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), CRLCC Jean Perrin, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Hematology, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-CHU Grenoble, Laboratoire Hubert Curien [Saint Etienne] ( LHC ), Institut d'Optique Graduate School ( IOGS ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP), Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Toulouse III - Paul Sabatier ( UPS ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Hôpital d'enfants, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Hematology, and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]

Subjects
Male, Transplantation Conditioning, MESH : Recurrence, MESH : Transplantation Conditioning, MESH : Aged, Graft vs Host Disease, MESH: Epidemiologic Methods, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Recurrence, MESH : Female, MESH : Graft Survival, MESH: Transplantation Conditioning, MESH: Treatment Outcome, MESH: Aged, MESH : Prognosis, MESH: Middle Aged, Graft Survival, MESH : Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Middle Aged, MESH : Adult, Prognosis, Treatment Outcome, surgical procedures, operative, MESH: Young Adult, Histocompatibility, Splenectomy, Female, MESH: Primary Myelofibrosis, Adult, MESH: Graft Survival, MESH : Male, MESH : Young Adult, MESH: Graft vs Host Disease, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, MESH: Splenectomy, MESH : Epidemiologic Methods, MESH: Prognosis, Young Adult, MESH : Hematopoietic Stem Cell Transplantation, Humans, MESH : Middle Aged, MESH : Splenectomy, MESH: Hematopoietic Stem Cell Transplantation, Aged, MESH: Humans, MESH : Humans, MESH : Histocompatibility, MESH: Adult, MESH: Male, MESH: Recurrence, MESH: Histocompatibility, Primary Myelofibrosis, MESH : Primary Myelofibrosis, Epidemiologic Methods, MESH: Female
Abstract

International audience; Allogeneic haematopoietic stem-cell transplantation (HSCT) is the only curative treatment for myelofibrosis. We report an analysis of the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) registry including patients with myelofibrosis transplanted between 1997 and 2008. Potential risk factors affecting engraftment, non-relapse mortality (NRM), overall survival (OS) and progression-free survival (PFS) were analysed. One hundred and forty-seven patients, aged 20-68 (median 53) years, diagnosed with primary (53%) or secondary myelofibrosis underwent HSCT; 59% of patients were transplanted from a matched sibling donor. The conditioning regimen was myeloablative in 31% of patients. Ninety percent of the patients engrafted. Factors affecting favourably engraftment were splenectomy before HSCT, human leucocyte antigen (HLA) matched sibling donor, peripheral stem cell use as source of stem cells and absence of pre-transplant thrombocytopenia. Four-year OS, PFS and NRM survival were 39% (95%confidence interval [CI]: 31-50), 32% (95%CI: 24-43) and 39% (95%CI 30-48), respectively. Multivariate analysis indicated that HLA-identical sibling donor, chronic phase disease and splenectomy in men had favourable impact on OS.

Published
2011
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5. Prognostic value of the Geneva prediction rule in patients in whom pulmonary embolism is ruled out

Author

Bertoletti, L, Le Gal, G, Aujesky, D, Roy, P-M, Sanchez, Oliver Lope, Verschuren, F, Bounameaux, Henri, Perrier, Arnaud, Righini, Marc Philip, Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Division of General Internal Medicine (DGIM), Bern University Hospital, Service des Urgences (PMR), CHRU - ANGERS, Department of Pneumology and Intensive Care Unit (DPICU), Université Paris Descartes - Paris 5 (UPD5), Emergency Department (FV - ED), Saint Luc University Hospital, Department of Internal Medicine (AP), Geneva University Hospital (HUG), Université de Brest (UBO)-Université de Brest (UBO), Service d'angiologie et d'hémostase ( MR ), Groupe de recherche sur la thrombose ( GRT (EA 3065) ), Université Jean Monnet [Saint-Étienne] ( UJM ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Division of General Internal Medicine ( DGIM ), Service des Urgences ( PMR ), Department of Pneumology and Intensive Care Unit ( DPICU ), Université Paris Descartes - Paris 5 ( UPD5 ), Emergency Department ( FV - ED ), Department of Internal Medicine ( AP ), and Geneva University Hospital ( HUG )

Subjects
MESH: Pulmonary Embolism, Male, MESH : Aged, MESH: Epidemiologic Methods, France/epidemiology, Switzerland/epidemiology, MESH: Belgium, Belgium, Neoplasms, MESH : Cardiovascular Diseases, MESH : Female, MESH: Neoplasms, Cardiovascular Diseases/mortality, ddc:616, MESH: Aged, MESH : Prognosis, MESH: Middle Aged, MESH : Adult, Middle Aged, Prognosis, Cardiovascular Diseases, MESH : Pulmonary Embolism, Female, Neoplasms/mortality, France, MESH : Belgium, Respiratory Insufficiency, MESH : Decision Support Techniques, Switzerland, Adult, MESH : Switzerland, Respiratory Insufficiency/mortality, MESH : Male, MESH: Switzerland, Patient Readmission, MESH : Epidemiologic Methods, MESH: Prognosis, Decision Support Techniques, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Patient Readmission, Humans, Pulmonary Embolism/diagnosis, MESH : Middle Aged, MESH : France, Belgium/epidemiology, MESH : Patient Readmission, Aged, MESH: Humans, MESH : Humans, MESH: Cardiovascular Diseases, MESH: Decision Support Techniques, MESH: Adult, MESH : Respiratory Insufficiency, MESH : Neoplasms, MESH: Male, MESH: France, Patient Readmission/statistics & numerical data, Epidemiologic Methods, Pulmonary Embolism, MESH: Female, MESH: Respiratory Insufficiency, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVES: The prognosis of patients in whom pulmonary embolism (PE) is suspected but ruled out is poorly understood. We evaluated whether the initial assessment of clinical probability of PE could help to predict the prognosis for these patients. DESIGN: Retrospective analysis of data obtained during a prospective multicentre management study. SETTING: Six general and teaching hospitals in Belgium, France and Switzerland. SUBJECTS: In 1334 patients in whom PE was ruled out, 3-month mortality data were available (hospital readmission status was unknown for three patients) and clinical probability was evaluated with the revised Geneva score (RGS). MAIN OUTCOME MEASURES: Three-month mortality and readmission rates. RESULTS: Three-month mortality and readmissions rates were 3% and 19%, respectively and differed significantly depending on the RGS-determined PE probability group (P

Published
2011
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6. Prognostic value of phosphorylated STAT3 in advanced rectal cancer: a study from 104 French patients included in the EORTC 22921 trial

Author

Bernadette Kantelip, Harouna Zaki, Francine Arbez-Gindre, Mariette Mercier, Franck Monnien, Christophe Borg, Christiane Mougin, Jean-François Bosset, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Service d'oncologie Médicale, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), 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), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Service d'Anatomie pathologique [CHRU Besançon], and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)

Subjects
Male, Oncology, MESH: Neoplasm Proteins, Pathology, MESH: Combined Modality Therapy, Colorectal cancer, medicine.medical_treatment, MESH : Aged, medicine.disease_cause, MESH: Epidemiologic Methods, law.invention, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH : Phosphorylation, 0302 clinical medicine, MESH: Aged, 80 and over, Randomized controlled trial, law, MESH : Tumor Markers, Biological, MESH : STAT3 Transcription Factor, MESH : Female, Phosphorylation, MESH : Rectal Neoplasms, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, 0303 health sciences, MESH : Cell Nucleus, MESH: Middle Aged, MESH : Prognosis, MESH: STAT3 Transcription Factor, Anatomical pathology, MESH : Chemotherapy, Adjuvant, General Medicine, Middle Aged, MESH : Adult, Prognosis, Combined Modality Therapy, Neoplasm Proteins, 3. Good health, Treatment Outcome, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, France, Adult, STAT3 Transcription Factor, MESH: Cell Nucleus, medicine.medical_specialty, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, MESH: Prognosis, MESH : Epidemiologic Methods, Pathology and Forensic Medicine, 03 medical and health sciences, MESH : Neoplasm Proteins, Internal medicine, Biomarkers, Tumor, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : France, Aged, 030304 developmental biology, Cell Nucleus, Chemotherapy, MESH: Humans, Oncogene, MESH: Phosphorylation, Rectal Neoplasms, business.industry, MESH : Humans, Cancer, MESH: Rectal Neoplasms, MESH: Adult, medicine.disease, MESH: Male, Clinical trial, MESH: France, MESH: Tumor Markers, Biological, Epidemiologic Methods, Carcinogenesis, business, MESH : Combined Modality Therapy, MESH: Female
Abstract

International audience; BACKGROUND: Signal transducer and activator of transcription 3 (STAT3) has been implicated as an oncogene in several neoplastic diseases. However, the biological effects of STAT3 have not been extensively studied in rectal carcinogenesis. AIMS: To evaluate STAT3 activation in advanced rectal cancers and its association with clinicopathological variables and prognosis. METHODS: Nuclear immunohistochemical expression of phosphorylated STAT3 (p-STAT3) was studied in 104 advanced rectal cancers (T3-T4). All patients were participating in the EORTC 22921 trial to assess whether preoperative chemoradiotherapy followed by postoperative chemotherapy improved overall and progression-free survival. RESULTS: Nuclear p-STAT3 expression was detected in 37.5% of rectal cancer patients. No correlation was observed between p-STAT3 and any clinicopathological variables tested. However, patients with tumours positive for p-STAT3 had significantly improved overall survival. CONCLUSION: These results highlight an unexpected role for nuclear p-STAT3 expression in advanced rectal cancers and need further investigation to clarify this finding.

Published
2010
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7. Lymphoma in patients treated with anti-TNF: results of the 3-year prospective French RATIO registry.: Lymphoma complicating anti-TNF therapy

Author

Mariette , Xavier, Tubach , Florence, Bagheri , Haleh, Bardet , Michel, Berthelot , Jean-Marie, Gaudin , Philippe, Heresbach , Denis, Martin , Antoine, Schaeverbeke , Thierry, Salmon , Dominique, Lemann , Marc, Hermine , Olivier, Raphael , Martine, Ravaud , Philippe, Service de rhumatologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Pharmacoépidémiologie : Evaluation de l'exposition et du risque médicamenteux, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse], Service de médecine interne et rhumatologie, Centre Hospitalier Régional d'Orléans (CHRO)-Hôpital de la source, Service de Rhumatologie, Hôtel-Dieu, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], Hôpital de St Brieuc, CHU Bordeaux [Bordeaux], Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Laboratoire d'Hématologie, Centre Hospitalier Régional d'Orléans (CHR)-Hôpital de la source, Service d'hépato-gastro-entérologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Toulouse III - Paul Sabatier ( UPS ), Centre Hospitalier Régional d'Orléans ( CHR ) -Hôpital de la source, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-Hôpital Michallon, Service de Gastroentérologie, Hôpital Pontchaillou, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]

Subjects
MESH: Antirheumatic Agents, Lymphoma, MESH: Registries, MESH : Male, MESH : Aged, MESH: Arthritis, MESH: Epidemiologic Methods, MESH : Lymphoma, MESH : Epidemiologic Methods, Anti-TNF, immune system diseases, hemic and lymphatic diseases, MESH: Immunocompromised Host, MESH : Middle Aged, MESH : Female, Rheumatoid arthritis, MESH : France, MESH : Immunosuppressive Agents, MESH : Tumor Necrosis Factor-alpha, MESH: Aged, MESH: Middle Aged, MESH: Humans, MESH : Humans, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Arthritis, MESH : Immunocompromised Host, MESH : Antirheumatic Agents, MESH: Male, MESH: France, MESH: Tumor Necrosis Factor-alpha, Spondylarthropathies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Immunosuppressive Agents, Safety, MESH: Lymphoma, MESH: Female, MESH : Registries
Abstract

International audience; OBJECTIVE: To describe cases of lymphoma associated with anti-TNF therapy, identify risk factors, estimate the incidence and compare the risks for different anti-TNF agents. METHODS: A national prospective registry was designed (Research Axed on Tolerance of bIOtherapies; RATIO) to collect all cases of lymphoma in French patients receiving anti-TNF therapy from 2004 to 2006, whatever the indication. A case-control analysis was conducted including two controls treated with anti-TNF per case and an incidence study of lymphoma with the French population was used as the reference. RESULTS: 38 cases of lymphoma, 31 non-Hodgkin's lymphoma (NHL) (26 B cell and five T cell), five Hodgkin's lymphoma (HL) and two Hodgkin's-like lymphoma were collected. Epstein-Barr virus was detected in both of two Hodgkin's-like lymphoma, three of five HL and one NHL. Patients receiving adalimumab or infliximab had a higher risk than those treated with etanercept: standardised incidence ratio (SIR) 4.1 (2.3-7.1) and 3.6 (2.3-5.6) versus 0.9 (0.4-1.8). The exposure to adalimumab or infliximab versus etanercept was an independent risk factor for lymphoma in the case-control study: odds ratio 4.7 (1.3-17.7) and 4.1 (1.4-12.5), respectively. The sex and age-adjusted incidence rate of lymphoma was 42.1 per 100 000 patient-years. The SIR was 2.4 (95% CI 1.7 to 3.2). CONCLUSION: The two to threefold increased risk of lymphoma in patients receiving anti-TNF therapy is similar to that expected for such patients with severe inflammatory diseases. Some lymphomas associated with immunosuppression may occur, and the risk of lymphoma is higher with monoclonal-antibody therapy than with soluble-receptor therapy.

Published
2010
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8. Early referral to the rheumatologist for early arthritis patients: evidence for suboptimal care. Results from the ESPOIR cohort

Author

Fautrel , Bruno, Benhamou , Mathilde, Foltz , Violaine, Rincheval , Nathalie, Rat , Anne-Christine, Combe , Bernard, Berenbaum , Francis, Bourgeois , Pierre, Guillemin , Francis, Saraux , Alain, Rhumatologie, Université Paris Diderot - Paris 7 ( UPD7 ), Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre de coordination, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, CHRU Brest - Service de Rhumatologie ( CHU - BREST - Rhumato ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Centre d'Investigation Clinique ( CIC - Brest ), Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institute of Biomedical Engineering, École Polytechnique de Montréal (EPM), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Sorbonne Université - Faculté de Médecine - École de sages-femmes Saint-Antoine (SU ESF), Sorbonne Université (SU), Station de Technologie des Produits Végétaux (URTPV), Institut National de la Recherche Agronomique (INRA), Université de Lorraine (UL), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Université Montpellier 1 - UFR de Médecine (UM1 Médecine), Université Montpellier 1 (UM1), Hôpital Lapeyronie [Montpellier] (CHU), Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and CHU Pitié-Salpêtrière [AP-HP]

Subjects
Male, Multivariate analysis, Time Factors, MESH : Aged, MESH: Epidemiologic Methods, MESH : Referral and Consultation, MESH : Early Diagnosis, MESH : Guideline Adherence, Arthritis, Rheumatoid, 0302 clinical medicine, MESH: Practice Guidelines as Topic, MESH: Early Diagnosis, Pharmacology (medical), MESH : Female, 030212 general & internal medicine, MESH: Quality of Health Care, Disease management (health), skin and connective tissue diseases, Referral and Consultation, ComputingMilieux_MISCELLANEOUS, MESH: Aged, MESH: Arthritis, Rheumatoid, MESH: Middle Aged, MESH : Quality of Health Care, Middle Aged, MESH : Adult, 3. Good health, MESH : Practice Guidelines as Topic, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, MESH: Young Adult, Rheumatoid arthritis, Cohort, MESH: Guideline Adherence, Practice Guidelines as Topic, Female, MESH: Clinical Competence, Clinical Competence, France, Guideline Adherence, Health Services Research, Family Practice, MESH: Health Services Research, MESH : Time Factors, Adult, musculoskeletal diseases, medicine.medical_specialty, Referral, Adolescent, MESH : Family Practice, MESH : Male, MESH : Health Services Research, MESH : Young Adult, MESH : Epidemiologic Methods, 03 medical and health sciences, MESH: Referral and Consultation, Young Adult, Rheumatology, Internal medicine, MESH : Adolescent, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, medicine, Humans, MESH : Middle Aged, MESH : France, MESH: Family Practice, Aged, Quality of Health Care, 030203 arthritis & rheumatology, MESH: Adolescent, MESH: Humans, business.industry, MESH: Time Factors, MESH : Humans, MESH: Adult, medicine.disease, MESH : Clinical Competence, MESH: Male, MESH: France, Early Diagnosis, MESH : Arthritis, Rheumatoid, Physical therapy, Managed care, business, Epidemiologic Methods, MESH: Female, Rheumatism, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVE: To assess the time to access a rheumatologist (TTAR) by early arthritis (EA) patients participating in a nationwide incidental cohort (ESPOIR) and compare it with European League Against Rheumatism (EULAR) recommendations, which recommends rapid referral, ideally within 6 weeks, to a rheumatologist for patients presenting with EA. METHODS: Eight hundred and thirteen patients with EA were included in the cohort between 2002 and 2005. The inclusion criteria were 18-70 years old, two or more swollen joints, symptom duration from 6 weeks to 6 months and possible RA diagnosis. TTAR was defined as the time between the first synovitis and first visit to a rheumatologist. TTAR and satisfaction of the EULAR guidelines were investigated by multiple linear and logistic regressions. RESULTS: Mean TTAR was 76 days; only 46.2% of patients were seen by a rheumatologist within the EULAR-recommended time frame. Patients' patterns of accessing medical care substantially affected access to specialized care: mean TTAR was 58 days for patients who directly scheduled an appointment with the rheumatologist and 78 days for those referred by their general practitioner (P < 0.0007). Only 57.2 and 44.5%, respectively, were able to consult a rheumatologist within 6 weeks. Multivariate analysis confirmed the significant impact of indirect access on TTAR, after adjustment for EA characteristics and medical density in the region. CONCLUSIONS: Significant disparities were identified in the care of EA patients in terms of early access to a rheumatologist. More effort is needed to optimize the physicians' knowledge about EA and to improve the efficiency of medical networks.

Published
2010
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9. Echinococcosis in Ningxia Hui Autonomous Region, northwest China

Author

Philip S. Craig, Malcolm K. Jones, Donald P. McManus, Tao Sun, Gail M. Williams, Patrick Giraudoux, Dominique A. Vuitton, Yu Rong Yang, Ningxia Medical College, Biomedical Sciences Research Institute, University of Salford, WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Molecular Parasitology Unit, University of Queensland [Brisbane]-The Queensland Institute of Medical Research-Australian Centre for International and Tropical Health and Nutrition ( ACITH ), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition (ACITH)

Subjects
Veterinary medicine, MESH: Chlamydia Infections, MESH : Echinococcus multilocularis, MESH: Epidemiologic Methods, MESH : Echinococcosis, MESH: Echinococcus granulosus, 030308 mycology & parasitology, 0302 clinical medicine, MESH : Specimen Handling, Epidemiology, MESH : Socioeconomic Factors, MESH: Animals, MESH : Female, Echinococcus granulosus, MESH: Echinococcosis, Pulmonary, Ultrasonography, 0303 health sciences, biology, MESH : Antigens, Bacterial, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, MESH: Cervix Uteri, Echinococcosis, MESH: China, MESH: Predictive Value of Tests, 3. Good health, Infectious Diseases, MESH : Time Factors, MESH : Echinococcosis, Pulmonary, China, medicine.medical_specialty, MESH: Socioeconomic Factors, Echinococcosis, Pulmonary, MESH: Polyethylene Terephthalates, 030231 tropical medicine, MESH: Chlamydia trachomatis, Echinococcus multilocularis, MESH : Family Health, MESH : Epidemiologic Methods, 03 medical and health sciences, MESH: Echinococcosis, MESH : Immunoenzyme Techniques, Environmental health, medicine, Animals, Humans, MESH : China, MESH : Predictive Value of Tests, MESH: Specimen Handling, MESH: Immunoenzyme Techniques, Family Health, MESH: Echinococcus multilocularis, MESH: Humans, business.industry, Cystic echinococcosis, MESH : Echinococcus granulosus, Public health, MESH : Chlamydia trachomatis, MESH: Time Factors, MESH : Humans, Public Health, Environmental and Occupational Health, medicine.disease, biology.organism_classification, Socioeconomic Factors, MESH : Chlamydia Infections, MESH : Cervix Uteri, MESH: Family Health, MESH : Polyethylene Terephthalates, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Animals, Rural area, Epidemiologic Methods, business, MESH: Female, MESH: Antigens, Bacterial
Abstract

International audience; Cystic echinococcosis (CE), caused by Echinococcus granulosus, and alveolar echinococcosis (AE), due to E. multilocularis, are endemic to large areas of north and northwest China. Here we review features of a severe focus of AE and CE in Ningxia Hui Autonomous Region (NHAR), northwest China. We describe for NHAR the results of surveys of hospital surgical and clinical records, including treatment of AE and CE, and active community detection of asymptomatic/early-stage cases and patient follow-up using questionnaire analysis, ultrasound examinations and serology. We compare the key risk factors for both AE and CE in this setting with those reported from other areas. In addition, we document the socio-economic factors impacting on treatment and control of AE and CE. This update indicates that echinococcosis continues to be highly endemic in NHAR and exemplifies the serious public health problem that the disease presents, particularly in poor rural areas. Extensive community surveys of echinococcosis are required throughout northwest China, especially in rural communities. These will enable earlier detection of echinococcosis cases, thereby improving treatment outcomes, and reveal the true epidemiological picture regarding the disease in this region, with a view to developing and implementing new strategies for future control.

Published
2008
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10. Survival of cancer patients in France: a population-based study from The Association of the French Cancer Registries (FRANCIM)

Author

Xavier Troussard, Marc Colonna, C. Bessaguet, Anne-Valérie Guizard, Pascale Grosclaude, Nicole Bourdon-Raverdy, Brigitte Trétarre, Claire Schvartz, Anne Jaffre, P.M. Carli, Florence Molinié, Jean Faivre, Arlette Danzon, Erik-André Sauleau, Anne Marie Bouvier, Guy Launoy, Nadine Bossard, Patrick Arveux, Nabil Maarouf, Jacques Estève, Michel Velten, Marc Maynadié, Aurélien Belot, Laurent Remontet, Service de Biostatistiques [Lyon], Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), FRANCIM, Réseau des registres français du cancer, Département des maladies chroniques et traumatismes, Institut de Veille Sanitaire (INVS), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Vesin, Aurélien, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), 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), Hospices Civils de Lyon ( HCL ), Laboratoire Biostatistique-Santé ( LBS ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Hospices Civils de Lyon ( HCL ) -Centre National de la Recherche Scientifique ( CNRS ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )

Subjects
Male, Oncology, Cancer Research, MESH: Registries, Colorectal cancer, MESH : Aged, MESH: Epidemiologic Methods, 0302 clinical medicine, MESH: Aged, 80 and over, MESH : Child, Prostate, Neoplasms, MESH: Child, MESH : Female, MESH: Neoplasms, Registries, 030212 general & internal medicine, Child, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH: Middle Aged, Relative survival, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, MESH : Adult, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, France, Adult, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], medicine.medical_specialty, Adolescent, MESH : Male, Population, MESH : Epidemiologic Methods, 03 medical and health sciences, MESH : Adolescent, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH : France, education, Lung cancer, Survival analysis, Aged, MESH: Adolescent, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, Cancer, MESH: Adult, medicine.disease, MESH : Neoplasms, MESH: Male, Surgery, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, business, MESH: Female, MESH : Registries
Abstract

International audience; We present the main results of the first population-based cancers survival study gathering all French registry data. Survival data on 205,562 cancer cases diagnosed between 01/01/1989 and 31/12/1997 were analysed. Relative survival was estimated using an excess rate model. The evolution of the excess mortality rate over the follow-up period was graphed. The analysis emphasised the effect of age at diagnosis and its variation with time after diagnosis. For breast and prostate cancers, the age-standardised five-year relative survivals were 84% and 77%, respectively. The corresponding results in men and women were 56% versus 58% for colorectal cancer and 12% versus 16% for lung cancer. For some cancer sites, the excess mortality rate decreased to low values by five years after diagnosis. For most cancer sites, age at diagnosis was a negative prognostic factor but this effect was often limited to the first year after diagnosis.

Published
2007
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11. Hospital and community surveys reveal the severe public health problem and socio-economic impact of human echinococcosis in Ningxia Hui Autonomous Region, China

Author

Donald P. McManus, X. Pan, S. K. Yang, Yu Rong Yang, Tao Sun, S. Hu, Patrick Giraudoux, Gail M. Williams, X. P. Li, Philip S. Craig, Dominique-Angèle Vuitton, L. Cheng, X. Liu, Ningxia Medical College, Biomedical Sciences Research Institute, University of Salford, WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté (UFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Brain imaging (LIAMA), Laboratoire Franco-Chinois d'Informatique, d'Automatique et de Mathématiques Appliquées (LIAMA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique (CNRS)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique (CNRS), Molecular Parasitology, University of Queensland [Brisbane]-Queensland Institute of Medical Research-Australian Centre for International and Tropical Health and Nutrition (ACITH), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), Brain imaging ( LIAMA ), Laboratoire Franco-Chinois d'Informatique, d'Automatique et de Mathématiques Appliquées ( LIAMA ), Centre de Coopération Internationale en Recherche Agronomique pour le Développement ( CIRAD ) -Institut National de la Recherche Agronomique ( INRA ) -Chinese Academy of Sciences [Changchun Branch] ( CAS ) -Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique ( CNRS ) -Centre de Coopération Internationale en Recherche Agronomique pour le Développement ( CIRAD ) -Institut National de la Recherche Agronomique ( INRA ) -Chinese Academy of Sciences [Changchun Branch] ( CAS ) -Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institute of Automation - Chinese Academy of Sciences-Centre National de la Recherche Scientifique ( CNRS ), Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition ( ACITH ), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Institute of Automation - Chinese Academy of Sciences-Institut National de Recherche en Informatique et en Automatique (Inria)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS)-Institute of Automation - Chinese Academy of Sciences-Institut National de Recherche en Informatique et en Automatique (Inria)-Chinese Academy of Sciences [Changchun Branch] (CAS)-Institut National de la Recherche Agronomique (INRA)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Laboratoire Chrono-environnement (UMR 6249) (LCE), and Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition (ACITH)

Subjects
Male, Cost effectiveness, MESH : Aged, MESH: Hospitalization, MESH : Child, Preschool, MESH : Echinococcosis, MESH: Epidemiologic Methods, MESH: Length of Stay, 030308 mycology & parasitology, 0302 clinical medicine, MESH: Aged, 80 and over, MESH : Child, MESH: Child, Epidemiology, 80 and over, MESH : Population Surveillance, MESH : Socioeconomic Factors, MESH : Female, Child, Echinococcus granulosus, MESH: Echinococcosis, Pulmonary, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, 0303 health sciences, MESH: Middle Aged, biology, Mortality rate, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Pulmonary, Health Care Costs, Middle Aged, MESH : Adult, Echinococcosis, MESH: Infant, MESH: China, 3. Good health, Hospitalization, MESH : Length of Stay, Treatment Outcome, Infectious Diseases, Child, Preschool, Population Surveillance, MESH : Hospitalization, Female, Public Health, MESH: Public Health, MESH : Health Care Costs, Adult, MESH : Echinococcosis, Pulmonary, China, medicine.medical_specialty, MESH: Socioeconomic Factors, Echinococcosis, Pulmonary, Adolescent, MESH : Male, 030231 tropical medicine, MESH : Public Health, MESH: Health Care Costs, MESH : Treatment Outcome, Echinococcus multilocularis, MESH : Epidemiologic Methods, MESH: Population Surveillance, 03 medical and health sciences, MESH: Echinococcosis, MESH : Adolescent, medicine, Humans, MESH : China, MESH : Middle Aged, Preschool, MESH : Aged, 80 and over, Disease burden, Aged, MESH: Adolescent, MESH: Humans, business.industry, Public health, MESH : Humans, MESH: Child, Preschool, Public Health, Environmental and Occupational Health, Infant, MESH: Adult, Length of Stay, biology.organism_classification, medicine.disease, MESH: Male, Surgery, Socioeconomic Factors, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, business, MESH: Female, Demography
Abstract

International audience; A comprehensive study of human echinococcosis (caused by Echinococcus granulosus or E. multilocularis), including assessment of hospital records, community surveys and patient follow-up, was conducted in Ningxia Hui Autonomous Region (NHAR), China. In contrast to hospital records that showed 96% of echinococcosis cases were caused by cystic echinococcosis (CE), 56% of cases detected in active community surveys were caused by alveolar echinococcosis (AE). The AE and CE cases co-existed frequently in the same village, even occurring in the same patient. A serious public health problem caused by echinococcosis was evident in southern NHAR, typified by: a long diagnostic history for both AE and CE (7.5 years) compared with a shorter treatment history (4.7 years); a significant mortality rate (39%) caused by AE in one surveyed village, where patients had no previous access to treatment; family aggregation of CE and AE cases; a high proportion of both AE (62.5%) and CE (58%) in females; a high rate of recurrent surgery (30%) for CE demonstrated by surgical records; and frequent symptomatic recurrences (51%) because of discontinuous or sporadic access to chemotherapy for AE. The disease burden for both human AE and CE is thus very severe among these rural communities in NHAR, and this study provides the first attempt to determine the costs of morbidity and surgical intervention of human CE and AE cases both at the hospital and community level in this setting. This information may be useful for assessing the cost effectiveness of designing effective public health programs to control echinococcosis in this and other endemic areas in China and elsewhere.

Published
2006
Full Text
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