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Sevestre MA, Belizna C, Durant C, Bosson JL, Vedrine L, Cajfinger F, Debourdeau P, Farge D. Compliance with recommendations of clinical practice in the management of venous thromboembolism in cancer: the CARMEN study. ACTA ACUST UNITED AC 2014; 39:161-8. [PMID: 24746736 DOI: 10.1016/j.jmv.2014.03.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 02/28/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Cancer is associated with venous thromboembolism in 20% of patients. In such patients, thrombosis is difficult to treat, associated with bleeding, recurrence, and death. Specific treatments for venous thromboembolism in cancer are recommended. Guidelines have been implemented in many countries and international guidelines have been recently developed. We evaluated the adhesion to national French guidelines via a survey of cancer patients treated for venous thromboembolism. METHODS A national cross-sectional observational study evaluated the adhesion to guidelines in hospitalized patients. Good clinical practice was defined as initial 10-day treatment with injectable molecules followed by long-term treatment with low molecular weight heparin for at least 3 months. Demographic data, cancer type, stage, treatment, risk factors and type of thrombosis, were recorded. RESULTS Five patients were included in 47 centers. Overall adhesion to guidelines was present in 59% (55-63%) of patients (295/500). During initial treatment, adhesion was high (487/496; 98%) but dropped (296/486; 62%) during the long-term maintenance. In patients with renal insufficiency, only a fourth of them received the adequate treatment. A majority of patients had metastatic disease (64%). Cancer sites were gastro-intestinal (25%), gynecologic (23%), pulmonary (21%), hematological (14%), urologic (10%), or other (8%). Lung and hematological malignancies were significantly associated with the highest and lowest rates of adhesion. CONCLUSION Adhesion to national guidelines for treatment of venous thromboembolism in cancer is not optimal. Good compliance is observed during initial treatment, but drops after 10 days, underlying the need for further education to achieve a better implementation on a national level.
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Achille A, Espitia O, Perrin F, Durant C, Masseau A, Ponge T, Connault J, Néel A, Hamidou M, Agard C. Sclérodermie systémique du sujet âgé : étude rétrospective de 27 patients diagnostiqués après 70ans. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.035] [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]
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Daguze J, Aubert H, Durant C, Soltner E, Barbarot S, Stalder JF. Maladie de Whipple et purpura vasculaire. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.542] [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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Kogge A, Durant C, Aubert H, Barbarot S, Bernier C. Purpura isolé des grands plis révélant une primo-infection à parvovirus B19. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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30
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Katchakourian L, Durant C, Graveleau J, Lestang E, Penhoat M, Masseau A, Néel A, Toquet C, Agard C, Morineau N, Hamidou M. Artérite temporale avec aortite malgré traitement par anti-CD52 (alemtuzumab) pour une leucémie lymphoïde chronique. Intérêt du TEP scan. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Artifoni M, Ternisien C, Durant C, Pistorius M, Hamidou M, Connault J. Évaluation qualitative des recherches d’antiphospholipides et devenir des patients suspects de SAPL au CHU de Nantes. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Artifoni M, Chemel M, Connault J, Loussouarn D, Graveleau J, Hamidou M, Durant C. Nécroses digitales inaugurales d’une maladie de Horton : une présentation atypique d’une maladie fréquente. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Leloup P, Le Bras M, Mirallie E, Barbarot S, Durant C. [Cushing's syndrome revealed by a chronic sore]. Ann Dermatol Venereol 2013; 140:407-9. [PMID: 23663721 DOI: 10.1016/j.annder.2013.01.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/14/2013] [Indexed: 11/27/2022]
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Dary M, Durant C, Brunet A, Lintz F, Mary M. Lymphome osseux primitif multifocal. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Georgin-Lavialle S, Roux X, Ackermann F, Durant C, Ranque B, Arlet JB. Intérêt de la PET en médecine interne : étude multicentrique prospective de 161 cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.034] [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]
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36
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Prey S, Ezzedine K, Doussau A, Grandoulier AS, Barcat D, Chatelus E, Diot E, Durant C, Hachulla E, de Korwin-Krokowski JD, Kostrzewa E, Quemeneur T, Paul C, Schaeverbeke T, Seneschal J, Solanilla A, Sparsa A, Bouchet S, Lepreux S, Mahon FX, Chene G, Taïeb A. Imatinib mesylate in scleroderma-associated diffuse skin fibrosis: a phase II multicentre randomized double-blinded controlled trial. Br J Dermatol 2012; 167:1138-44. [PMID: 23039171 DOI: 10.1111/j.1365-2133.2012.11186.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Imatinib mesylate is a potent inhibitor of platelet-derived growth factor and transforming growth factor-β signalling pathways which may play a role in systemic sclerosis (SSc)-associated skin changes. OBJECTIVES We aimed primarily at assessing the efficacy of imatinib mesylate in scleroderma skin fibrosis. METHODS We performed a phase II double-blinded trial on patients with scleroderma with either morphoea involving > 20% of body surface area or SSc with extensive skin involvement: modified Rodnan Skin Score (mRSS) ≥ 20/51. Each patient was randomized to receive either imatinib mesylate 400 mg or placebo daily for a total of 6 months, and then was followed up 6 months after therapy discontinuation. Skin fibrosis was assessed by mRSS and measurement of the dermal thickness using skin biopsies performed at inclusion and at 6 months of treatment. In addition, quality of life (Dermatology Life Quality Index and modified Health Assessment Questionnaire for Scleroderma) was recorded at each visit, and pulmonary function before and after intervention. RESULTS Twenty-eight patients were included in the study with a mean age of 48·9 years (range 30-71): 25 had a diagnosis of a SSc and three of diffuse cutaneous scleroderma. Demographic data, frequency of organ involvement of SSc and mRSS were comparable between groups. At 6 months, the proportion of variation of mRSS from inclusion was not statistically significantly different between the two groups (median +0·10 in imatinib group vs. -0·16 in placebo group, P = 0·098). Similarly, changes in dermal thickness, quality of life and diffusion capacity for carbon monoxide were not significantly different between groups. CONCLUSIONS This study failed to demonstrate the efficacy of imatinib 400 mg daily to improve skin fibrosis of diffuse scleroderma after 6 months of treatment based on validated outcome measurements.
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Durant C, Hadj-Khelifa S, Lei J, Badaoui A, Moreau AS, Traineau R, Farge D, Decaux O. La Schtroumpfette en Australie. Rev Med Interne 2012; 33:536-8. [DOI: 10.1016/j.revmed.2012.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 06/07/2012] [Indexed: 10/28/2022]
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Hervier B, Morell-Dubois S, Durant C, Uzunhan Y, Devilliers H, Mathian A, Hatron PY, Masseau A, Hamidou M, Hachulla E, Amoura Z, Benveniste O. Intérêt de la 18F-FDG tomographie par émission de positron au cours du syndrome des antisynthétases. Analyse rétrospective de 26 cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.012] [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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Bould H, Panicker V, Kessler D, Durant C, Lewis G, Dayan C, Evans J. Investigation of thyroid dysfunction is more likely in patients with high psychological morbidity. Fam Pract 2012; 29:163-7. [PMID: 21890841 DOI: 10.1093/fampra/cmr059] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mild or subclinical hypothyroidism [raised thyroid-stimulating hormone (TSH) but normal free thyroxine (T4)] affects 5-10% of adults. Symptoms are non-specific and TSH levels are needed for diagnosis. OBJECTIVES We explore the relationship between thyroid function and psychological distress and investigate the usefulness of an expert-designed Thyroid Symptom Questionnaire (TSQ) in identifying hypothyroidism. METHODS DEPTH (DEPression and THyroid) is a cross-sectional study of 325 patients recruited from general practices in Bristol, for whom thyroid function tests were requested by the GP. Subjects completed the TSQ, General Health Questionnaire (GHQ-12) and Patient Health Questionnaire (PHQ) and had blood tests for TSH and free T4. RESULTS The mean age was 45.7 years; 252 subjects (78%) were female; median TSH was 1.6. Psychological morbidity in this population is high: 54.2% have a GHQ-12 score >3, indicating psychological distress. We found no relationship between TSH and psychological distress [adjusted odds ratio 1.02 (95% confidence interval 0.91-1.13), P = 0.78]. The prevalence of hypothyroidism was 6.2% (95% confidence interval 3.8-9.5%). We found no evidence of an unadjusted association between TSQ score and subclinical hypothyroidism [adjusted odds ratio of 1.09 (95% confidence interval 0.95-1.24), P = 0.23]. CONCLUSIONS Those referred for thyroid function tests, although no more likely than others to have hypothyroidism, have high rates of psychological distress. When mild (subclinical) hypothyroidism is detected in patients with psychological distress, it is important that GPs are aware that this is likely to be coincidental rather than causal and offer appropriate treatment.
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Baraut J, Farge D, Jean-Louis F, Kesmandt H, Durant C, Verrecchia F, Michel L. Les cytokines dans la sclérodermie systémique. ACTA ACUST UNITED AC 2012; 60:127-39. [DOI: 10.1016/j.patbio.2009.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Accepted: 11/17/2009] [Indexed: 12/20/2022]
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41
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De Masson A, Bouaziz JD, Rybojad M, Peffault de Latour R, Robin M, Rodriguez-Otero P, Durant C, Socie G, Bagot M. EF/SSc overlap syndrome and aplastic anaemia resistant to immunosuppressive therapy. Rheumatology (Oxford) 2012; 51:762-4. [DOI: 10.1093/rheumatology/ker406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Connault J, Masseau A, Audrain M, Durant C, Agard C, Néel A, Pottier P, Planchon B, Hamidou M. Étude monocentrique rétrospective de 59 patients porteurs du syndrome des antiphospholipides (SAPL) : dépistage et correction des facteurs de risque cardiovasculaire lors des SAPL primaires et secondaires. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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43
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Farge-Bancel D, Lefort A, Mahé I, Algayres JP, Durant C, Roux X, Rapp C. Bienvenue au 64e congrès de la Société nationale française de médecine interne. Rev Med Interne 2011; 32 Suppl 2:S201-2. [DOI: 10.1016/j.revmed.2011.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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44
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Cajfinger F, Debourdeau P, Drouet L, Durant C, Elalamy I, Farge-Bancel D. Risque thromboembolique et prise en charge du cancer du sein. ONCOLOGIE 2011. [DOI: 10.1007/s10269-011-2089-6] [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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45
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Hervier B, Hamidou M, Haroche J, Durant C, Mathian A, Amoura Z. Systemic lupus erythematosus associated with ANCA-associated vasculitis: an overlapping syndrome? Rheumatol Int 2011; 32:3285-90. [PMID: 21805174 DOI: 10.1007/s00296-011-2055-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 07/10/2011] [Indexed: 01/12/2023]
Abstract
Systemic lupus erythematosus (SLE) and small-sized vessel vasculitis are usually two distinguishable autoimmune diseases. However, a vasculitis may be found in the course SLE but rarely corresponds to an ANCA-associated vasculitis (AAV). We report four cases of de novo SLE associated with AAV, our aim being to discuss the clinical significance of this association. We included four patients fulfilling the criteria for both SLE and AAV and followed in two different university hospitals between 1996 and 2009. In light of a 20-year literature review (25 described clinical cases), we discussed the etiopathogeny of such an association. All patients presented a severe renal involvement (creatininemia ranging from 120 to 370 μmol/l) and thrombopenia (ranging from 45,000 to 137,000 platelets/mm(3)). The other main clinical symptoms were arthritis (n = 3), serositis (n = 2) and intra-alveolar hemorrhage (n = 2). An inflammatory syndrome was noticed at diagnosis in all cases. ANCAs were MPO-ANCAs in all cases. Two out of these four patients were also diagnosed with antiphospholipid syndrome. The frequency of this association seems not fortuitous. Although the etiopathogenic mechanisms of such an association remain to be more precisely described, several clinical, histological and immunological features support the hypothesis of the existence of a SLE-AAV overlapping syndrome. Moreover, clinicians must be aware of such an overlapping syndrome, notably because its initial presentation can be very severe.
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Lefebvre M, Capito C, Durant C, Hervier B, Grossi O. Tungiasis: a poorly documented tropical dermatosis. Med Mal Infect 2011; 41:465-8. [PMID: 21703785 DOI: 10.1016/j.medmal.2011.05.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 02/16/2011] [Accepted: 05/17/2011] [Indexed: 11/16/2022]
Abstract
Tungiasis is the parasitic skin disease caused by the sand flea Tunga penetrans, also called the jigger flea, found in most intertropical countries. The contamination occurs when walking barefoot in the sand: adult females actively burrow the foot epidermis leading to self-limited lesions responsible for itching or pain. The diagnosis is made on clinical observation and history of travelling to an endemic country. The simple treatment is surgical extraction of the flea.
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Connault J, Durant C, Pottier P, Josnin M, Hello M, Ponge T, Planchon B, Hamidou M. Expression clinique vasculaire sévère et précoce de la mutation homozygote MTHFR chez 3 patientes tabagiques. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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48
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Daikeler T, Durant C, Martin T, Launay D, Gluckman E, Farge D. Incidence et facteurs de risque de développer une maladie auto-immune secondaire après transplantation de cellules souches hématopoïétique pour maladie auto-immune sévère. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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49
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Khelifa SH, Durant C, Sibon D, Keshtmand H, Farge D. Réactivation virale EBV après autogreffe de cellules souches hématopoïétiques pour sclérodermie systémique. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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50
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Martin J, Audrain M, Durant C, Rimbert M, Fromont P, Hamidou M. Neutropénies auto-immunes. Rev Med Interne 2011; 32:26-32. [DOI: 10.1016/j.revmed.2010.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 03/05/2010] [Accepted: 04/11/2010] [Indexed: 11/30/2022]
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