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Prado F, González M, Hernández M, Guzmán C, Chaulon M, Cóbar S, Donis M, Rivera C. Preliminary study of total levels of dissolved arsenic in drinking water of different zones of the Municipality of Guatemala, Department of Guatemala. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hernández M, González M, Guzmán C, Chaulon M, Donis M, Cóbar S, Prado F, Rivera C. Drug intoxications reported by the Laboratory of Toxicology of the Department of Toxicology of the University of San Carlos of Guatemala from 2011 to 2015. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pundhir P, Tuda C, Vincentelli C, Morlote D, Rivera C. Scolecobasidium granulomatous pneumonia and abscess - an emerging opportunistic fungal pathogen: a case report. Int J STD AIDS 2016; 28:94-96. [PMID: 27105660 DOI: 10.1177/0956462416646688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Scolecobasidium sp. are commensal soil and water thermophilic dematiaceous fungi. They are commonly isolated as contaminants from respiratory secretions due to their abundant presence in water supplies, but they are also rare yet emerging culprits producing severe opportunistic infections in immunocompromised individuals. The most consistent presentations reported in literature are life-threatening pulmonary and cerebral granulomatous lesions.
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Riquet M, Pricopi C, Rivera C, Badia A, Arame A, Dujon A, Foucault C, Le Pimpec Barthes F, Fabre E. [Lung cancer measuring 1cm or less: A miniature subset requiring surgery]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:171-178. [PMID: 27113613 DOI: 10.1016/j.pneumo.2015.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/23/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Lung cancer measuring 1cm or less has an apparently very good outcome. However, the characteristics permitting their oncological management are unappreciated. PATIENT AND METHOD We reviewed 187 patients with such a cancer (145 men and 42 women, mean age 60.2years) and studied the type of surgery performed, the pTNM, and the histological features. RESULTS Surgery (19 wedge-resections, 12 segmentectomies, 136 lobectomies, 20 pneumonectomies) was complete (R0) in 97.3%. The tumors, each precisely defined among 98 adenocarcinomas (52.4%), 83 squamous cell carcinomas (44.4%), and 6 others, measured 1mm to 10mm:<5mm (n=41), 6 to 9mm (n=43), and 10mm (n=103). There were 161 pT1 (86.1%), 22 pT2 (11.8%) and 4 pT3; 148 pN0 (79.6%), 18 pN1 (9.7%) and 20 pN2 (10.7%). pN1 and pN2 were present in tumors<5mm (12/41, 29.3%) as well as in the others (26/146, 17.8% P=0.11). Histological examination frequently discovered visceral pleura involvement (tumors:<5mm 12.2% (5/41), 6 to 9mm 7% (3/43), 10mm 13.6% (14/103), P=0.53) and lympho-vascular invasion (12.9%). Five-year survival rate (66.4%) was adversely influenced by age, type of resection, pN and histological features. The survival rate was not better in tumor<5mm. CONCLUSION Surgical resection allows the local control of lung cancers<1cm and their complete histological study, a key issue in the therapy of the future, which renders surgery an absolute must even in very small tumors.
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Rivera C, Rivera S, Fabre E, Pricopi C, Le Pimpec-Barthes F, Riquet M. [Consequences of tobacco smoking on lung cancer treatments]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:136-141. [PMID: 25727658 DOI: 10.1016/j.pneumo.2014.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 11/10/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
In France, in 2010, tobacco induced 81% of deaths by lung cancer corresponding to about 28,000 deaths. Continued smoking after diagnosis has a significant impact on treatment. In patients with lung cancer, the benefits of smoking cessation are present at any stage of disease. For early stages, smoking cessation decreases postoperative morbidity, reduces the risk of second cancer and improves survival. Previous to surgery, smoking cessation of at least six to eight weeks or as soon as possible is recommended in order to reduce the risk of infectious complications. Tobacco could alter the metabolism of certain chemotherapies and targeted therapies, such as tyrosine kinase inhibitors of the EGF receptor, through an interaction with P450 cytochrome. Toxicity of radiations could be lower in patients with lung cancer who did not quit smoking before treatment. For patients treated by radio-chemotherapy, overall survival seems to be better in former smokers but no difference is observed in terms of recurrence-free survival. For advanced stages, smoking cessation enhances patients' quality of life. Smoking cessation should be considered as full part of lung cancer treatment whatever the stage of disease.
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Salazar B, Zhang C, Hoffman K, Zhang Y, Rivera C, Boone T, Munoz A. MP30-19 CORRELATION BETWEEN SPINAL CORD INJURY FORCE AND ELECTROMYOGRAPHIC CHARACTERISTICS OF THE LOWER URINARY TRACT IN FEMALE RATS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rivera C, Rosales J. Genotoxic damage and occupational exposure to formaldehyde in anatomic pathology laboratory workers. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Riquet M, Rivera C, Pricopi C, Badia A, Arame A, Dujon A, Foucault C, Le Pimpec-Barthes F, Fabre E. [Clinical and paraclinical prognostic factors in non-small cell lung cancer surgery]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:264-274. [PMID: 26315208 DOI: 10.1016/j.pneumo.2015.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/10/2015] [Accepted: 06/02/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Lung cancer prognosis is mainly based on the TNM, histology and molecular biology. Our aim was to analyze the prognostic value of certain clinical and paraclinical variables. PATIENTS AND METHODS We studied among 6105 patients operated on, divided during 3 time-periods (1979 to 2010), the following prognostic factors: type of surgery, pTNM, histology, age, sex, smoking history, clinical presentation, and paraclinical variables. RESULTS Postoperative mortality was 4% (243/6105), rate of complications was 23.3% (1424/6105). The 5-year overall survival was 43.2% and 10-year was 27%. Best survival was observed after complete resection (R0) (P<10(-6)), lobectomy (P<10(-6)), lymph node dissection (P=0.0006), early pTNM stages (P<10(-6)), absence of a solid component in adenocarcinoma. Other pejorative factors were: male gender (P=10(-5)), age (P=0.0000002), comorbidity (P=0.016), history of cancer (P<10(-5)), postoperative complications (P=0.0018), FEV lower than 80% (P=0.0000025), time-periods (P<10(-6)). All these factors were confirmed by multivariate analysis, except gender. Smoking was not poor prognostic factor in univariate analysis (P=0.09) but became significant in the multivariate one (P=0.013). CONCLUSION Medical and human factors, and the general physiological state, play an important role in prognosis after surgery. We do not know their exact meaning and, like studies on chemotherapy, they justify special research.
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Rivera C, Lumley T. Using the whole cohort in the analysis of countermatched samples. Biometrics 2015; 72:382-91. [PMID: 26393818 DOI: 10.1111/biom.12419] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 07/01/2015] [Accepted: 08/01/2015] [Indexed: 11/29/2022]
Abstract
We present a technique for using calibrated weights to incorporate whole-cohort information in the analysis of a countermatched sample. Following Samuelsen's approach for matched case-control sampling, we derive expressions for the marginal sampling probabilities, so that the data can be treated as an unequally-sampled case-cohort design. Pseudolikelihood estimating equations are used to find the estimates. The sampling weights can be calibrated, allowing all whole-cohort variables to be used in estimation; in contrast, the partial likelihood analysis makes use only of a single discrete surrogate for exposure. Using a survey-sampling approach rather than a martingale approach simplifies the theory; in particular, the sampling weights need not be a predictable process. Our simulation results show that pseudolikelihood estimation gives lower efficiency than partial likelihood estimation, but that the gain from calibration of weights can more than compensate for this loss. If there is a good surrogate for exposure, countermatched sampling still outperforms case-cohort and two-phase case-control sampling even when calibrated weights are used. Findings are illustrated with data from the National Wilms' Tumour Study and the Welsh nickel refinery workers study.
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Medrow L, Handu D, Brown K, Berger-Marshall M, Rivera C, Forgac T. Food Insecurity/Food Banking Dietetic Internship Concentration Prepares Future RDNs for Working with Food Insecure Populations. J Acad Nutr Diet 2015. [DOI: 10.1016/j.jand.2015.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rivera C, Mamondi V, Lavin Fueyo J, Jouglard EF, Pogany L, Sánchez MC, Prina M, Roizen M, Esandi ME, Berra S. Health-related quality of life in children with and without chronic conditions: A multicenter study. ARCH ARGENT PEDIATR 2015. [PMID: 26294144 DOI: 10.5546/aap.2015.404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Chronic conditions (CCs) in the early stages of life may have an impact on various dimensions of health-related quality of life (HRQoL) in children. OBJECTIVE To compare HRQoL in children with confirmed CCs, reported CCs, and without CC. POPULATION AND METHOD Cross-sectional study conducted in 2012 in the context of a larger research study carried out at schools in Córdoba and Bahía Blanca, and at Hospital Italiano of Buenos Aires and Hospital Prof. Dr. Juan P. Garrahan at Buenos Aires. The presence of a chronic condition was established by medical diagnosis at the hospital or as reported by schoolchildren's caregivers. Eight-to-twelve year-old children completed the KIDSCREEN-52 questionnaire on HRQoL, a pubertal development scale, and a family financial resource scale. The association between CCs and HRQoL adjusted by sex, age, pubertal development, maternal education level, and socioeconomic level was estimated. RESULTS Six hundred and seventy children/ caregiver dyads participated; 13.3% (n= 89) had confirmed CCs, 14.5% (n= 97) were schoolchildren with reported CCs, and the rest corresponded to healthy schoolchildren. Their average age was 10.2 years old (standard deviation= 1.01); 54.8% were girls. Having a confirmed CC was associated with a higher frequency of low physical wellbeing (odds ratio |-OR-|: 2.61; 95% confidence interval |-95% CI-|:1.43-4.76), while the presence of a reported CC was associated with a low score in psychological well-being (OR: 1.96; 95% CI: 1.06-3.63), self-perception (OR: 2.22; 95% CI: 1.28-3.87), and parent relations (OR: 2.04; 95% CI: 1.21-3.44). CONCLUSIONS Children with confirmed CCs showed a higher frequency of physical discomfort, and those with reported CCs showed discomfort in psychosocial areas compared to children without CCs.
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Le Pimpec-Barthes F, Pricopi C, Chevalier B, Boucherie J, Grand B, Bagan P, Das Neves Pereira J, Badia A, Arame A, Rivera C. P-198PRELIMINARY PROSPECTIVE STUDY ON DOUBLE-LUMEN TUBE INTUBATION AND ONE-LUNG VENTILATION CONDITIONS IN THORACIC SURGERY: DO THEY IMPACT POSTOPERATIVE MORBIDITY? Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pereira JCDN, Pricopi C, Rivera C, Hubsch J, Bagan P, Badia A, Arame A, Grand B, Murphy W, Le Pimpec-Barthes F. V-110EXTREME FAST-TRACK REHABILITATION IN THORACIC SURGERY: INTERNATIONAL BICENTRIC PROSPECTIVE STUDY. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pricopi C, Rivera C, Abdennadher M, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M. [Place of limited resections and prognostic factors in non-small lung cancer]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:207-216. [PMID: 25794877 DOI: 10.1016/j.pneumo.2014.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 09/15/2014] [Accepted: 09/21/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Results of surgery for non-small-cell lung cancer (NSCLC) are poorer after limited resection, wedge and segmentectomy, than after lobectomy. Guidelines recommend avoiding wedge-resection, which new techniques (radiofrequency ablation and cyberknife) tend to replace. This work aimed to study the wedge-resection carcinological value. PATIENTS AND METHODS NSCLC without previous other cancer history and neoadjuvant therapy measuring less than 31 millimetres and operated from 1980 to 2009 were reviewed. Analyzed variables were: location, gender, age, FEVS, type of resection, histology, pT and pN. RESULTS There were 66 wedge-resections (10.9%), 32 segmentectomies (5.3%), 507 lobectomies (83.8%), nine postoperative deaths (1.5%), 136 complications (22.5%), 557 complete resections (R0=92%); 72.2% of NSCLC upper lobe location (437/605). Age was more advanced in wedge-resection and segmentectomy, FEVS lower and NSCLC most often a squamous cell pN0 and pStage I carcinoma than in lobectomy. Lymphadenectomy was not performed in half the wedge-resections. Five-year survival rates were poorer after wedge-resection: 50% versus segmentectomy 59.8% (P=0.09), and lobectomy 66% (P=0.0035), but the number of recurrences was similar. Multivariate analysis demonstrated that age, FEVS, type of surgery and lymphadenectomy, pN in pTNM were the only prognosis factors. CONCLUSION Wedge-resection is less carcinological than segmentectomy when the patient-status and NSCLC location allow performing the latter, but more than the new techniques, because of its pathological yield, when the patient-status and nodule peripheral location allow wedging.
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Rivera C, Ilizaliturri-Sánchez V, Camacho-Galindo J, González-Ugalde H, Alba-Sánchez I. [Total femoral replacement. Three case reports and literature review]. ACTA ORTOPEDICA MEXICANA 2015; 29:223-227. [PMID: 27187000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Currently hip and knee joint replacement were performed frequently at orthopedic centers. However, these surgeries do not last forever and thus revision procedures are required. The latter usually involve complications like bone loss that may compromise implant stability. METHODS Three hip and knee arthroplasty revisions were performed from 2006 to 2011, which warranted the total replacement of the femur and the joints involved. The purpose of this paper is to describe our experience with these implants used in arthroplasty revision surgery. RESULTS A standardized postoperative management protocol was used in all patients. They required debridement and specific antibiotic therapy. They had a significant improvement in the pain visual analog scale (VAS) (the score went from 8 to 2.3, p ‹ 0.05) and in function, measured with the WOMAC score (from a preoperative score of 21.6 to 55, p ‹ 0.05). CONCLUSIONS Total femoral replacement is an infrequent, demanding and complex salvage surgery that represents an alternative to the disarticulation of the pelvic limb at the end stage of prosthetic disease. This is a feasible option used to improve patient functionality and decrease residual capacity for performing activities independently.
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Sánchez MV, Agüero R, Rivera C. Plantas hospederas de los virus más importantes que infectan el melón, <i>Cucumis melo</i> (Cucurbitaceae) en Costa Rica. REV BIOL TROP 2015. [DOI: 10.15517/rbt.v46i1.19348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Las especies hospederas naturales de los virus (PRSV, WMV-2. CMV y ZYMV) que infectan el cultivo de melón (Cucumis me/o L.) para la exportación en Costa Rica se identificaron en plantaciones comerciales de dos fincas ubicadas, una en la provincia de Guanacaste, y la otra en la provincia de Puntarenas. En ambas fincas se cultiva el melon con irrigación durante la época seca, pero su manejo cultural es diferente. La finca A con una larga trayectoria en el cultivo de melón en rotación con maíz. sorgo y arroz, y con poco control de malezas; mientras que la finca B con una corta trayectoria en la producción del melón y un mayor control de malezas. La diversidad de especies vegetales fue estudiada en cuadrantes de 100 m' en cinco diferentes comunidades de plantas previamente seleccionada, en la finca A (cultivo, canal de drenaje, charral, potrero mejorado, y semi-bosque) y tres en la finca B (cultivo, charral, pastizal natural, semibosque). El número de cuadrantes estudiados dependió del área total cultivada en cada una de las fincas. Toda, las especies de plantas representadas en cada cuadrante se recolectaron e identificaron pero solo aquella, especies que presentaron síntomas virales en el campo fueron analizadas por EUSA para determinar la presencia de los cuatro virus estudiados. La diversidad de especies, porcentaje de cobertura y épocade aparición de las especies hospederas fue monitoreada durante un año calendario en cinco fechas diferentes. Un total de 86 y 72 especies de plantas fueron identificadas en las tlncas A y B respectivamente. Catorce encontradas positivas por lo menos para uno de los cuatro virus. Los cuatro virus fueron encontrados en cada finca en cada fecha de muestreo indicando que la permanencia y abundancia de alguna, especies hospederas garantiza la permanencia de los cuatro virus en el campo como fuente de inóculo primario para la próx.ima siembra. Varia, especies de plantas hospederas silvestres previamente no informadas en la literatura fueron encontradas para PRSV, WMV-2 y ZYMV.
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Pinninti M, Rivera C, Cho C, Thohan V, Hastings T, Cheema O, Downey F, Crouch J, Weiss E, Sulemanjee N. The Effect of Severity of Renal Dysfunction on Clinical Outcomes in Patients With Continuous-Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Rivera C, Pecuchet N, Wermert D, Pricopi C, Le Pimpec-Barthes F, Riquet M, Fabre E. [Obesity and lung cancer: incidence and repercussions on epidemiology, pathology and treatments]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:37-43. [PMID: 25681316 DOI: 10.1016/j.pneumo.2014.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Obesity and lung cancer are major public health problems. The purpose of this work is to review the data concerning this association. METHOD We report clinical and epidemiological data on obesity and discuss the impact on the incidence of lung cancer, as well as the safety and efficiency of anti-tumor treatments. RESULTS Obesity does not contribute to the occurrence of lung cancer, unlike other malignancies. Patients may be more likely to undergo treatment at lower risk. Regarding surgery, obesity makes anaesthesia more difficult, increases the operative duration but does not increase postoperative morbidity and mortality. Chemotherapy and radiotherapy seem to be administered according to the same criteria as patients with normal weight. Paradoxically, survival rates of lung cancer are better in obese patients as well after surgery than after non-surgical treatment. CONCLUSION Obesity is related to many neoplasms but not to lung cancer. Regarding long-term survival all treatments combined, it has a favorable effect: this is the "obesity paradox".
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Rivera C, Chevalier B, Fabre E, Pricopi C, Badia A, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M. [Lung cancer surgery and cirrhosis]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:12-19. [PMID: 25687820 DOI: 10.1016/j.pneumo.2014.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/28/2014] [Accepted: 09/05/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Lung cancer is the leading cause of death by cancer and cirrhosis is the fourteenth, all causes included. Surgery increases postoperative risks in cirrhotic patients. Our purpose was to analyze this point in lung cancer surgery. METHODS We collected, among 7162 patients, the data concerning those operated for lung cancer (n=6105) and compared patients with hepatic disease (n=448) to those presenting other medical disorder (n=2587). We analyzed cirrhotic patients' characteristics (n=49). RESULTS Five-year survival of patients with hepatic disease was lower (n=5657/6105): 35.3% versus 43.8% for patients with no hepatic disease, P=0.0021. Survival of cirrhotic patients was not statistically different from the one of patients with other hepatic disorder, but none survived beyond 10 years (0% versus 26.4%). Surgery in cirrhotic patients consisted in one explorative thoracotomy, three wedges resections, two segmentectomies, 33 lobectomies and 10 pneumonectomies. Postoperative mortality (8.2%; 4/49) was not different for patients without hepatic disease (4.2%; 239/5657) (P=0.32), as well as the rate of complications (40.8%; 20/49 and 24.8%; 1404/5657, P=0.11). Only one postoperative death was associated to a hepatic failure. Multivariate analysis pointed age, histological subtype of the tumour and stage of disease as independent prognosis factors. CONCLUSION When cirrhosis is well compensated, surgical resection of lung cancer can be performed with acceptable postoperative morbidity and satisfactory rates of survival. Progressive potential of this disease is worse after five years.
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Arame A, Rivera C, Mordant P, Pricopi C, Foucault C, Badia A, Le Pimpec Barthes F, Riquet M. [Pneumonectomy for benign disease: indication and factors affecting the postoperative course]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:1-4. [PMID: 25131368 DOI: 10.1016/j.pneumo.2014.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 03/28/2014] [Accepted: 04/02/2014] [Indexed: 06/03/2023]
Abstract
Pneumonectomy for benign disease is rare but may generate more postoperative morbimortality than when performed for lung cancer. We questioned this assessment and retrospectively reviewed 1436 pneumonectomies and 54 completions of which 82 and 10 performed for benign disease (5.7% and 18.5%, respectively): left n=65 and right n=27. Indications were: post-tuberculosis destroyed lung (n=37), aspergilloma (n=18), bronchiectasis (n=19), infection (n=5), congenital malformations (n=5), inflammatory pseudotumor (n=3), trauma (n=2), post-radiation (n=2) and mucormycosis (n=1). Pneumonectomy consisted of 48 standard and 44 pleuro-pneumonectomies. Stump coverage by flaps was performed in 66.3% (61/92). Complications occurred in 21.7% (20/92) and postoperative deaths in 7.6% (7/92, of which 5 with fungal infections), which was not different than what was observed in lung cancer. There was no difference in fistula formation and mortality regarding the side, the type of resection and the protective role of stump coverage. Considering patients with fungal infections versus others, mortality was 26.3% (n=5/19) and 2.7% (n=2/74), respectively (P=0.0028). Pneumonectomy for benign disease achieves cure with acceptable mortality and morbidity. However, presence of fungal infection should raise the attention for possibility of increased postoperative risks.
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Abdennadher M, Rivera C, Gibault L, Fabre E, Pricopi C, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M. [Mucoepidermoid tracheo-bronchial tumors in adulthood. A series of 22 cases]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:27-36. [PMID: 25687822 DOI: 10.1016/j.pneumo.2014.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/18/2014] [Accepted: 09/21/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Mucoepidermoid tumours (TME) are rare tumours arising from the submucosal glands of the tracheobronchial tree. The majority of these tumours develop in a benign fashion but some of them are malignant. The latter can be easily mistaken for adenosquamous carcinomas. PATIENTS AND METHOD We have reviewed 22 patients suffering from TME observed over a period of 25 years. Two arose from the trachea and 20 from the cartilaginous bronchi; 12 of these tumours had macroscopic and histological criteria of low-grade malignancy, 4 had macroscopic and 6 macroscopic and microscopic criteria of high grade malignancy. RESULTS Prognosis of the latter was very poor and no survival observed after 6 years follow-up, a behavior similar to that observed in non-small cell lung carcinomas and adenosquamous carcinomas. CONCLUSION The best treatment of these orphan tumours remains surgery.
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Le Pimpec Barthes F, Rivera C, Fabre E, Arame A, Pricopi C, Badia A, Foucault C, Dujon A, Riquet M. [Lung cancer surgery in a single-lung]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:5-11. [PMID: 25457222 DOI: 10.1016/j.pneumo.2014.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/12/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The diagnosis of a second lung cancer in a patient with a previous medical history of lung cancer is no longer a rarity. Also, it is possible to observe a new location in a patient who underwent pneumonectomy in the past. Surgery remains the best treatment. Our objective was to overview this subject. PATIENTS AND METHODS Among 5611 patients operated in our institution, 186 (3.3%) had metachronous cancer and 17 had previous pneumonectomy (0.7% of pneumonectomies and 0.2% of NSCLC treated in our department). The procedure was diagnostic and therapeutic in 88% of cases (n=15). RESULTS There were 16 males and 1 female, mean age was 62.5-years. All were smokers (11 were former smokers) and 6 had other medical history. Mean FEV was 52% (range 35-95%). Types of resection were 2 lobectomies, 4 segmentectomies, and 11 wedge resections. There were no postoperative deaths, but two complications. Histological subtype of the first and second cancer was the same in 11 patients. All patients were pN0 after second surgery. The long-term survival (median 33 months) was 35.3% at 5-years and 14.1% at 10-years. Two patients treated with pneumonectomy for their first cancer were pN2. Patients who underwent upper right lobectomy for treatment of their second cancer survived longer than 5-years. CONCLUSION Surgical resection for lung cancer on single-lung is associated with acceptable morbidity and mortality. Prolonged survival can be achieved in selected patients.
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Arame A, Rivera C, Borik W, Mangiameli G, Abdennahder M, Pricopi C, Bagan P, Badia A, Le Pimpec Barthes F, Riquet M. [Lung cancer surgery in solid organ transplanted patients]. REVUE DE PNEUMOLOGIE CLINIQUE 2014; 70:315-321. [PMID: 25131366 DOI: 10.1016/j.pneumo.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The incidence of lung cancer is reputed to be higher and prognosis worse in solid organ transplant recipients than in the general population. Our purpose was to review the results of surgery in this group of patients. METHODS We retrospectively reviewed 49 male and 6 female patients; mean aged 60.6 years (38-85). Transplanted organ was heart (n = 37), kidney (n=12), liver (n = 5) and both-lungs (n = 1); 48 patients had smoking habits and 42 heavy comorbidities (76.4%). Lung cancer was diagnosed during surveillance (78.2%, n = 43) or because of symptoms (21.8%, n = 12). We reviewed TNM and other main characteristics, among them histology (squamous-cell-carcinoma n = 23, adenocarcinomas n = 24, others n = 8). RESULTS Surgery consisted of: exploratory thoracotomy (n = 2), wedge resections (n = 6), segmentectomy (n = 1), lobectomy (n = 42), pneumonectomy (n = 4). Postoperative mortality was 7.4% (n = 4) and complication rate 34.5% (n = 19). Five-year survival rate was 46.4% (65.4% for stage I patients, n = 25). Among the 35 dead patients during follow-up, 14 died of their lung cancer (40%). Two had been re-operated from another lung cancer: one after 3 and 8 years who survived 16 years, and the other after 2 years who survived 70 months. CONCLUSIONS Surgery results are good and postoperative events acceptable despite theoretically increased risks. This also supports performing a close follow-up of transplanted patients and particularly those with smoking history in view of detecting lung cancer appearing at an early stage.
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Riquet M, Rivera C, Pricopi C, Le Pimpec Barthes F. [Lung cancer surgery and HIV infection]. Rev Mal Respir 2014; 31:771-2. [PMID: 25391512 DOI: 10.1016/j.rmr.2014.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/04/2014] [Indexed: 10/24/2022]
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Riquet M, Rivera C, Pricopi C, Abdennadher M, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F. [Place and role of the pleura in non-small cell lung cancer dissemination]. REVUE DE PNEUMOLOGIE CLINIQUE 2014; 70:269-278. [PMID: 25131365 DOI: 10.1016/j.pneumo.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/19/2014] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The pleural involvement (PLI) in non-small cell lung cancer (NSCLC) has a poor prognosis, even though it might be very heterogeneous. PATIENTS AND METHODS A multicentric retrospective descriptive study was performed over 2329 patients who were operated for NSCLC between 1979 and 2010. The patients with PLI were classified in P(Parietal)PLI and V(visceral)PLI and then each subdivided : VPLI to peripheric (VPLI-P) and fissural (VPLI-F) and PPLI to mediastinal (PPLI-M) and costal (PPLI-C). Characteristics and survival were compared between the subgroups as well as with patients without PLI (WPLI, n=1439). RESULTS The sex-ratio was 2.8 (males: n=1713). The PLI patients were significantly younger, with a less sex-ratio, less R0 resections (96% versus 98.7%, P=0.000076), and less N0 (60% vs 70%, P<10(-6)) as their 5-year survival (45.7% vs 55.5%, P<10(-6)). The PLI was related to the size of NSCLC (P<10(-6)) and N2 involvement (P=0.0020). It was less frequent after neoadjuvant treatment (36.2% vs 39.1% P=0.03). In the VPLI-F or PPLI-M, pneumonectomies were more frequent (P<10(-6)). In VPLI-P (n=196/561), there were more pN1 and pN2 (P=0.0065) with a 5-year survival of 42.9% vs 54.4%, P=0.013. In multivariate analysis, the PLI was not an independent prognostic factor contrary to age, sex, type of resection, pT and pN. CONCLUSION The pleura play a major role in NSCLC dissemination. Its involvement affects pN, the type of surgical resection and justifies the use of neoadjuvant treatment.
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