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Morice C, Brugière C, Stefan A, Clément C, Comoz F, Creveuil C, Gouarin S, Verneuil L. Implication de l’Epstein-Barr virus dans l’exanthème maculopapuleux toxique bénin. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guillois B, Castel S, Beunard A, Blaizot X, Creveuil C, Proia-Lelouey N. Efficacité des programmes d’intervention précoce après l’hospitalisation sur le développement neurocomportemental des enfants prématurés. Arch Pediatr 2012; 19:990-7. [DOI: 10.1016/j.arcped.2012.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 06/25/2012] [Indexed: 10/26/2022]
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Zalcman G, Mazieres J, Scherpereel A, Margery J, Moro-Sibilot D, Parienti JJ, Gounant V, Riviere A, Monnet I, Molinier O, Lena H, Friard S, Duhamel JP, Audigier-Valette C, Robinet G, Creveuil C, Ligeza-poisson C, Morin F. IFCT-GFPC-0701 MAPS trial, a multicenter randomized phase III trial of pemetrexed-cisplatin with or without bevacizumab in patients with malignant pleural mesothelioma (MPM). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.tps7112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS7112 Background: MPM median OS does not exceed 13 months with pem/CDDP doublet. U.S. Intergroup phase II trial of gemcitabine/CDDP, with or without bevacizumab, gave an appealing 15.6 months median OS in the bevacizumab arm. French Intergroup aimed to test pem/CDDP with bevacizumab (PCB), in a randomized phase III trial. Methods: Eligible patients had unresectable histologically proved MPM, no prior chemo, PS 0-2, no thrombosis, nor bleeding. Primary endpoint: The primary outcome will be survival. The secondary endpoint will be Progression-Free Survival. Patients received pem 500 mg/m2, CDDP 75 mg/m2 (PC),at D1, and vitamin B12 +B9 substitution, with (arm B) or without bevacizumab (arm A), 15 mg/kg Q21D, for 6 cycles. Arm B nonprogressive patients received bevacizumab maintenance therapy until progression or toxicity. 445 patients to be recruited during a period 48 months, with at least 24 months of follow-up, and 385 events (deaths), will be needed to assure a power of 80% and detect at least a 4.3 months of median survival increase. This hypothesis leads to a Hazard Ratio (HR) of 1.33 and a 3-years survival of 14.7% in control arm and 23.6 % in experimental arm, with an absolute difference of 8.9% in survival rates. Accrual status: The first patient was included in February 2008. On January 31, 2012, 257 patients from 85 French centers had been enrolled. The end of accrual can be expected for September 2013. Ancillary studies: For molecular biomarker analyses, thoracoscopic tissue specimens (TS, ERCC1, MSH2, TUBB3, NF2, p16, RASSF1A methylation,15 microRNAs ) and blood samples (micro-RNAS, VEGF, osteopontin, SRMP) at diagnosis are centrally collected. Finally, a prospective study comparing PET-CT to standard CT with central blinded analysis, is currently on-going for evaluation of response, and accuracy of modified RECIST criteria for mesothelioma.
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de Fraipont F, Levallet G, Creveuil C, Bergot E, Beau-Faller M, Mounawar M, Richard N, Antoine M, Rouquette I, Favrot MC, Debieuvre D, Braun D, Westeel V, Quoix E, Brambilla E, Hainaut P, Moro-Sibilot D, Morin F, Milleron B, Zalcman G. An Apoptosis Methylation Prognostic Signature for Early Lung Cancer in the IFCT-0002 Trial. Clin Cancer Res 2012; 18:2976-86. [DOI: 10.1158/1078-0432.ccr-11-2797] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Levallet G, Bergot E, Antoine M, Creveuil C, Santos AO, Beau-Faller M, de Fraipont F, Brambilla E, Levallet J, Morin F, Westeel V, Wislez M, Quoix E, Debieuvre D, Dubois F, Rouquette I, Pujol JL, Moro-Sibilot D, Camonis J, Zalcman G. High TUBB3 expression, an independent prognostic marker in patients with early non-small cell lung cancer treated by preoperative chemotherapy, is regulated by K-Ras signaling pathway. Mol Cancer Ther 2012; 11:1203-13. [PMID: 22411898 DOI: 10.1158/1535-7163.mct-11-0899] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed the prognostic and predictive value of β-tubulin III (TUBB3) expression, as determined by immunohistochemistry, in 412 non-small cell lung cancer (NSCLC) specimens from early-stage patients who received neoadjuvant chemotherapy (paclitaxel- or gemcitabine-based) in a phase III trial (IFCT-0002). We also correlated TUBB3 expression with K-Ras and EGF receptor (EGFR) mutations in a subset of 208 cryopreserved specimens. High TUBB3 protein expression was associated with nonsquamous cell carcinomas (P < 0.001) and K-Ras mutation (P < 0.001). The 127 (30.8%) TUBB3-negative patients derived more than 1 year of overall survival advantage, with more than 84 months median overall survival versus 71.7 months for TUBB3-positive patients [HR, 1.58; 95% confidence interval (CI), 1.11-2.25)]. This prognostic value was confirmed in multivariate analysis (adjusted HR for death, 1.51; 95% CI, 1.04-2.21; P = 0.031) with a bootstrapping validation procedure. TUBB3 expression was associated with nonresponse to chemotherapy (adjusted HR, 1.31; 95% CI, 1.01-1.70; P = 0.044) but had no predictive value (taxane vs. gemcitabine). Taking account of these clinical findings, we further investigated TUBB3 expression in isogenic human bronchial cell lines only differing by K-Ras gene status and assessed the effect of K-Ras short interfering RNA (siRNA) mediated depletion, cell hypoxia, or pharmacologic inhibitors of K-Ras downstream effectors, on TUBB3 protein cell content. siRNA K-Ras knockdown, inhibition of RAF/MEK (MAP-ERK kinase) and phosphoinositide 3-kinase (PI3K)/AKT signaling, and hypoxia were shown to downregulate TUBB3 expression in bronchial cells. This study is the first one to identify K-Ras mutations as determinant of TUBB3 expression, a chemoresistance marker. Our in vitro data deserve studies combining standard chemotherapy with anti-MEK or anti-PI3K drugs in patients with TUBB3-overexpressing tumors.
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Bergot E, Levallet G, Creveuil C, Lechapt E, Zalcman G. [Prognostic and predictive biomarkers in non-small cell lung cancers. From conditioned registrations to routine molecular mapping of lung cancers: Methodological issues]. Presse Med 2011; 40:379-88. [PMID: 21376511 DOI: 10.1016/j.lpm.2011.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Accepted: 01/24/2011] [Indexed: 11/17/2022] Open
Abstract
Targeted therapies booming and new efficacious cytotoxics emergence in non-small cell lung cancers (NSCLC) deeply changed prognosis in some subsets of patients experiencing long survival. A priori identification (at time of diagnosis) of patients the most beneficiating from those often costly therapies is the new issue in thoracic oncology. For EGFR tyosine kinase inhibitors (TKI), molecular targeting relies on EGFR mutations diagnosis, that led to the first conditioned molecular-based registration for a drug in thoracic oncology, that was made easier in France by French NCI huge effort to sponsor the 28 regional molecular biology platforms. For the majority of classical cytotoxics used in adjuvant treatment after lung cancer surgical resection, biomarkers relying on immunohistochemistry still need further prospective validation steps before routine use. Prospective validation studies aimed to evaluate the ability of those biomarkers to predict not only response to therapy, but also survival with a specific treatment (predictive value), need large phase 3 trials with centralized biomarker analyses and rigorous statistical methods. French Intergroup (IFCT) has initiated such studies that will help to validate new biomarkers that we may use routinely in lung cancer in near future.
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Dayan J, Creveuil C, O’Keane V. Prenatal depression: role of childhood stressors, current stressors and past emotional disorders. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BackgroundVery few studies have conducted a multivariate analysis incorporating both the major predictors of depression in women, in accordance with comprehensive developmental models of depression, and specific stressors associated with the biological and psychosocial state of the mother-to-be.MethodologyWe used a cross-sectional cohort design to analyze the associations between prenatal depression and potential risk factors. 693 French-speaking women with singleton pregnancies at 20–28 weeks’ gestation were consecutively recruited. Fifty women with missing values were subsequently excluded from the analysis. Depressive symptoms were assessed on the Edinburgh Postnatal Depression Scale. Risk factors were either extracted from the computerized obstetric records or assessed by means of self-administered questionnaires. The associations between prenatal depression and the potential risk factors were assessed using log-binomial regression models to obtain a direct estimate of relative risk.Principal findingsThe following factors were found to be significant in the multivariate analysis: level of education, past psychiatric history, stress related to the health and viability of the fetus and stress related to severe marital conflicts or to serious difficulties at work. An association was also found with the previous delivery of a child with a major or minor birth defect. Univariate analyses revealed a strong association with childhood adversity (parental rejection and family secrets).ConclusionsOur study identifies several risk factors that could easily be assessed in clinical practice. It draws attention to the impact of previously delivering a child with a birth defect and to the association with childhood adversity.
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Dayan J, Creveuil C, Dreyfus M, Herlicoviez M, Baleyte JM, O'Keane V. Developmental model of depression applied to prenatal depression: role of present and past life events, past emotional disorders and pregnancy stress. PLoS One 2010; 5:e12942. [PMID: 20877652 PMCID: PMC2943912 DOI: 10.1371/journal.pone.0012942] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Accepted: 08/14/2010] [Indexed: 11/19/2022] Open
Abstract
Background Several risk factors for depression during pregnancy have already been established. However, very few studies have conducted a multivariate analysis incorporating both the major predictors of depression in women, in accordance with comprehensive developmental models of depression, and specific stressors associated with the biological and psychosocial state of the mother-to-be. Methodology/Principal Findings We used a cross-sectional cohort design to analyze the associations between prenatal depression and potential risk factors. 693 French-speaking women with singleton pregnancies at 20–28 weeks' gestation were consecutively recruited at Caen University Hospital. Fifty women with missing values were subsequently excluded from the analysis. Depressive symptoms were assessed on the Edinburgh Postnatal Depression Scale. Risk factors were either extracted from the computerized obstetric records or assessed by means of self-administered questionnaires. The associations between prenatal depression and the potential risk factors were assessed using log-binomial regression models to obtain a direct estimate of relative risk (RR). The following factors were found to be significant in the multivariate analysis: level of education (p<0.001), past psychiatric history (adjusted RR = 1.8, 95% confidence interval (CI): 1.1;2.8, p = 0.014), stress related to the health and viability of the fetus (adjusted RR = 2.6, 95% CI: 1.6;4.1, p<0.001), and stress related to severe marital conflicts (adjusted RR = 2.4, 95% CI: 1.5;3.9, p<0.001) or to serious difficulties at work (adjusted RR = 1.6, 95% CI :1.04;2.4, p = 0.031). An association was also found with the previous delivery of a child with a major or minor birth defect (adjusted RR = 2.0, 95% CI: 1.04;4.0, p = 0.038). Univariate analyses revealed a strong association with childhood adversity (parental rejection: RR = 1.8, 95% CI: 1.2;2.8, p = 0.0055 and family secrets: RR = 2.0, 95% CI: 1.2;3.1, p = 0.0046) and with lack of partner support (RR = 0.50, 95% CI: 0.30;0.84, p = 0.0086). Conclusions/Significance Our study identifies several risk factors that could easily be assessed in clinical practice. It draws attention to the impact of previously delivering a child with a birth defect. The association with childhood adversity warrants further study.
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Verneuil L, Gouarin S, Comoz F, Agbalika F, Creveuil C, Varna M, Vabret A, Janin A, Leroy D. Epstein-Barr virus involvement in the pathogenesis of hydroa vacciniforme: an assessment of seven adult patients with long-term follow-up. Br J Dermatol 2010; 163:174-82. [DOI: 10.1111/j.1365-2133.2010.09789.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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de Vienne CM, Creveuil C, Dreyfus M. Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: A cohort study. Eur J Obstet Gynecol Reprod Biol 2009; 147:151-6. [DOI: 10.1016/j.ejogrb.2009.08.006] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 06/23/2009] [Accepted: 08/18/2009] [Indexed: 11/16/2022]
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Dayan J, Creveuil C. Association between depressive symptoms during pregnancy and risk of pre-term delivery. Hum Reprod 2009; 24:2044; author reply 2044-5. [DOI: 10.1093/humrep/dep220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Boutemy J, Ollivier Y, Creveuil C, Zoulim A, Silva NM, Bienvenu B, Letellier P. Efficacité du cyclophosphamide dans le traitement de la maladie de Horton corticodépendante. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zalcman G, Levallet G, Bergot E, Antoine M, Creveuil C, Brambilla E, Dumontet C, Morin F, Depierre A, Milleron B. Evaluation of class III beta-tubulin (bTubIII) expression as a prognostic marker in patients with resectable non-small cell lung cancer (NSCLC) treated by perioperative chemotherapy (CT) in the phase III trial IFCT-0002. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7526 Background: IFCT-0002 phase III trial compared two timings of CT in early lung cancer, all before surgery (PRE) versus PERIoperative, and two CT regimens, CDDP-Gem vs. CBDCA-Pac. 528 patients were randomized. Paraffin embedded post- chemo pathological specimens were collected in the 490 non complete responder patients for tissue expression of the putative biomarker beta-tubulin III (bTubIII). Methods: 423 surgical pathological specimens with enough remaining viable tumor tissue after neoadjuvant chemo were processed for immunohistochemistry as published in the Bio-IALT study. A semi-quantitative score was attributed taking account the number of stained cells and the intensity of staining. Semi-quantitative scores were studied as continuous variables, without any pre- determined cut-off. Multivariate analysis for progression-free (PFS) and overall survival (OS) were corrected with Bonferroni-Holm method for multiple analyses. Median follow-up was 42 months. Results: bTubIII was the only IHC marker significantly associated with poor PFS in univariate (p=0.014) or multivariate analysis, adjusted for histology, T and stage (HR= 1.50 [1.07–2.10]; p=0.020). In patients with a pathological specimen showing a bTubIII positive immunostaining, median PFS was 30.6 months, versus 60.1 months (HR=1.46 [1.08–1.99]) for bTubIII negative patients. bTubIII IHC score remained predictive of poor OS in univariate (p= 0.0065) as in multivariate analysis (p=0.019 with Bonferroni correction, HR=1.75 [1.15–2.68] ). Median OS was not reached for bTubIII negative patients whereas it was 71.7 months in patients with bTubIII immunostaining of any intensity score (HR=1.61, [1.11–2.35]). Conclusions: This study showed a dramatic negative prognostic impact for bTubIII immunostaining in resectable early lung cancer. A subset of bTubIII expressing patients with poor prognosis did not take any advantage from perioperative chemo. Hence, those patients could rather have beneficiated from personalized adjuvant treatment with alternative approaches. No significant financial relationships to disclose.
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Girard B, Vardon D, Creveuil C, Herlicoviez M, Dreyfus M. Discontinuation of oxytocin in the active phase of labor. Acta Obstet Gynecol Scand 2009; 88:172-7. [PMID: 19169930 DOI: 10.1080/00016340802649816] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To show that early discontinuation of oxytocin will not increase the mean duration of the active labor phase in a clinically significant way. DESIGN Controlled non-inferiority study. SETTING Department of Obstetrics and Gynecology, University of Caen, Clemenceau Hospital, France. POPULATION A total of 138 women with singleton pregnancy and a vertex presentation of over 34 gestational weeks, presenting a medical indication of induction of labor or a dystocia at onset of labor, from May 2005 to June 2006. METHODS Two parallel groups were compared: continuation of oxytocin until delivery versus discontinuation of oxytocin at the onset of the active phase. The clinically acceptable increase in mean duration of the active phase of labor (non-inferiority margin) was set at 60 minutes. MAIN OUTCOME MEASURES Primary outcome measure was duration of the active labor phase. Secondary outcome measures included total duration of labor, parameters concerning oxytocin use, rates of uterine hyperstimulation and fetal heart rate (FHR) abnormalities, and mode of delivery. Some neonatal outcomes were also analyzed. RESULTS Equivalence of the two strategies (continuation vs. discontinuation of oxytocin) was not demonstrated (p=0.97 testing for non-inferiority), the active phase even being significantly longer by a mean of 113 minutes (p=0.0001 testing for superiority). The rates of cesarean sections, alterations of FHR and delivery hemorrhage were higher when oxytocin was continued, but not significantly. There were significantly more infants hospitalized in neonatology when oxytocin was continued (p=0.028). CONCLUSIONS Discontinuation of oxytocin at the onset of the active phase prolongs labor. We found no argument for discontinuing the infusion of oxytocin at the onset of the active phase.
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Grossetti E, Carles G, El Guindi W, Seve B, Montoya Y, Creveuil C, Dreyfus M. Selective prophylactic transfusion in sickle cell disease. Acta Obstet Gynecol Scand 2009; 88:1090-4. [DOI: 10.1080/00016340903134171] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Levallet G, Bergot E, Defraipont F, Creveuil C, Antoine M, Brambilla E, Beau-Faller M, Mounawar M, Favrot M, Hainaut P, Milleron B, Zalcman G. Étude des marqueurs immunohistochimiques (IHC) et moléculaires de résistance à la chimiothérapie péri-opératoire : protocole national Bio-IFCT 0002. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)75035-6] [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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Vardon D, Hors Y, Grossetti E, Creveuil C, Herlicoviez M, Dreyfus M. [Fetal pulse oximetry: clinical practice]. ACTA ACUST UNITED AC 2008; 37:697-704. [PMID: 18614298 DOI: 10.1016/j.jgyn.2008.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2006] [Revised: 01/15/2007] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess in current practice the application of our protocol of using fetal pulse oximetry during labor, to evaluate whether fetal scalp blood sampling can be reduced and to determinate reliability of fetal pulse oximetry on the prediction of poor neonatal outcomes. STUDY DESIGN Prospective observational unicenter cohort including 449 patients during two years. All pregnancies were singleton, greater than or equal to 37 weeks' gestation, cephalic presentation, and had non reassuring fetal heart rate. The poor neonatal outcome was defined by one of the followings: arterial umbilical cord pH<or=7.15, umbilical cord base deficit greater than or equal to 12 mmol/l, 5 min Apgar score less than or equal to 7, transfer in neonatal intensive care unit, secondary respiratory distress and death. RESULTS The use of fetal pulse oximetry was concordant with our protocol in more than 80% of cases. The frequency of fetal scalp blood sampling was significantly reduced from 9.9 to 8.6% after the introduction of our protocol. With a 30% threshold, diagnostical values of fetal oximetry for a poor neonatal outcome were 9.1% for sensitivity, 93.1% for specificity, 79.4% for negative predictive value and 25.9% for positive predictive value. With a 40% threshold, the diagnostic values were 74, 51.6, 88.2 and 28.9% respectively. CONCLUSION The strict application of our protocol allow a less aggressive management of labor with a significant decrease in fetal scalp blood sampling. This study shows that with a 40% threshold, fetal pulse oximetry could be considered as a reliable tool for the management of labor with no increase of poor neonatal outcomes. On the other hand, the threshold which could determine whether an abnormal fetal heart rate needs immediate intervention still remains unclear.
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Zalcman G, Beau-Faller M, Creveuil C, de Fraipont F, Mounawar M, Richard N, Bergot E, Favrot M, Morin F, Milleron B. Use of Ras effector RASSF1A promoter gene methylation and chromosome 9p loss of heterozygosity (LOH) to predict progression-free survival (PFS) in perioperative chemotherapy (CT) phase III trial IFCT-0002 in resectable non-small cell lung cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7500] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fouques Y, Mallick S, Frachet O, Le Toquin S, Creveuil C, Bensadoun H. Évaluation de la radiofréquence (TUNA™) dans le traitement de l’hypertrophie bénigne de prostate en chirurgie ambulatoire. Prog Urol 2007; 17:824-7. [PMID: 17633994 DOI: 10.1016/s1166-7087(07)92300-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Evaluating the effectiveness and feasibility of transurethral needle ablation (TUNA) for young patients with symptomatic benign hyperplasia (BPH) in outpatient care. MATERIAL AND METHODS From 2004 to 2005, 9 patients (mean age: 59.7 years) were treated with the TUNA device. The urinary function using the IPSS (International Prostate Symptom Score), the quality of life score (QOL-UR), the uroflowmetry, and the post-void residue, and the sexual function using the International Index of Erectile Function score (IIEF-5) were assessed. RESULTS Prior to thermotherapy, the mean IIEF-5 was 20.2. The mean preoperative IPSS and QOL-UR scores were respectively 25.2 and 5,6. Regarding uroflowmetry, the mean pre-treatment maximal urinary flow was 6 ml/s and the mean post-void residue was 167.1 mL. Patients' follow-up was at intervals of 3 months. With a mean follow-up of 9.5 months, 8 patients have achieved a better urinary status with a mean IPSS and QOL-UR score of 9.5 and 1.6 respectively (p<0.05). The mean maximal flow rate was improved (14 ml/s, p< 0,05). The post-void residue decreased but had no statistical significance. The IIEF-5 score remained unchanged. Only 4 complications including 3 urinary retentions and 1 prostatitis were revealed for 3 patients. No failure with radiofrequency thermal therapy was observed. CONCLUSION TUNA as a mini-invasive outpatient treatment for symptomatic BPH proved reliable and reproducible for young patients with preserved sexual function.
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Muris C, Girard B, Creveuil C, Durin L, Herlicoviez M, Dreyfus M. Management of premature rupture of membranes before 25 weeks. Eur J Obstet Gynecol Reprod Biol 2007; 131:163-8. [PMID: 16846673 DOI: 10.1016/j.ejogrb.2006.05.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 03/12/2006] [Accepted: 05/17/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of our study was to define the benefits and risks related to expectant management in the midtrimester rupture of membranes and to assess the prognostic factors in order to give objective informations to parents facing these obstetrical situations. STUDY DESIGN We conducted a retrospective study. The study population included 49 patients with premature rupture of membranes at 16-23 weeks' gestation during the period January 1998-June 2003. The main criterion for judgement was neonate survival. Statistical analysis included chi2-test for the qualitative variables and Student's test for the quantitative variables. The threshold for significance was 5%. RESULTS Twenty couples out of 49 chose medical termination of pregnancy. Among the 29 other pregnancies, the mean latency period was 2.1 weeks. The mean gestational age at delivery was 23.2 weeks. Nineteen patients were delivered after 22 weeks. The main prognostic factors were the initial amniotic fluid index (2.9 cm versus 0.8 cm) (p=0.042) and gestational age at delivery (26.7 weeks versus 22.6 weeks) (p<0.001). About 2% of the pregnancies were complicated by maternal infection. Eighty-three percent of the survivors had neonatal respiratory distress syndrome. 41.2% of them presented sepsis. We observed no cases of severe intraventricular haemorrhage. The number of infants born after 24 weeks of gestation and still alive at 1 week was 12, representing 24% of pregnancies and 63% of the infants born after 24 weeks. CONCLUSION Expectant management can be widely suggested to patients. However, termination of pregnancy is acceptable, in cases with a poor prognosis including anamnios and premature rupture of membranes before 21 weeks.
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Grossetti E, Vardon D, Creveuil C, Herlicoviez M, Dreyfus M. Rupture of the scarred uterus. Acta Obstet Gynecol Scand 2007; 86:572-8. [PMID: 17464586 DOI: 10.1080/00016340701257141] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the risk of uterine rupture of the scarred uterus according to mode of delivery in subsequent births recorded as spontaneous labour, labour induced by oxytocin, labour after ripening with prostaglandin E2, and planned cesarean section. METHODS Retrospective study of 2,128 births with a low transversal scar after a previous cesarean section. The study population was realised in a level III university hospital from 1995 to 2003. The association between mode of delivery and uterine rupture was studied in a multivariate logistic regression model, and adjusted for specific antenatal confounding factors. RESULTS Over 9 years, we collected 22 cases (1%), including 11 asymptomatic ruptures in a population of 2,128 scarred uteri out of 28,248 deliveries. Uterine rupture occurred at a rate of 0.3 per 100 among women with repeated cesarean delivery without labour, 1 per 100 among women with spontaneous onset of labour, 1.4 per 100 among women with oxytocin-induced labour, and 2.2 per 100 among women with prostaglandin cervical ripening. Compared to women with a planned cesarean section, women with spontaneous onset of labour were more likely to have uterine rupture (OR: 4.0; 95% CI: 0.8-42.0). A greater relative risk was observed among women with oxytocin-induced labour (OR: 4.3; 95% CI: 0.3-60.0), and particularly those with prostaglandin-induced labour (OR: 8.7; 95% CI: 1.5-97.3, p=0.01). CONCLUSION In women with a scarred uterus, prostaglandin E2 induction of labour is a risk factor for uterine rupture. The practice of a systematic cesarean section in cases with Bishop score<3, appropriate induction procedure, and rigorous monitoring of the labour, could make for a safer delivery.
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Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M, Tordjman S. Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 2006; 68:938-46. [PMID: 17079701 DOI: 10.1097/01.psy.0000244025.20549.bd] [Citation(s) in RCA: 235] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This article investigates the effects of antenatal depression and anxiety on spontaneous preterm birth resulting either from preterm labor or preterm premature rupture of membranes. METHODS We conducted a prospective cohort study of 681 women with singleton pregnancies consecutively recruited between 20 and 28 weeks of gestation in the Obstetrics Department of the French University Hospital of Caen. Most were of European ethnic origin and received early and regular antenatal care. The assessment of gestational age was based on ultrasound examination (occurring before 13 weeks of gestation for 94.9% of the women). Depression and anxiety were assessed using self-administered questionnaires: the Edinburgh Postnatal Depression Scale and the Spielberger State-Trait Anxiety Inventory. Logistic regression analysis, controlling for sociodemographic factors (e.g., maternal age, occupation) and obstetric factors (e.g., previous preterm birth, cervical or vaginal infection), provided adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Spontaneous preterm birth occurred in 31 women (4.8%). The rate of spontaneous preterm birth was significantly higher among women with high depression scores (9.7%) as opposed to other women (4.0%) even after adjustment for potential confounding factors (adjusted OR = 3.3, 95% CI = 1.2-9.2, p = .020). Anxiety was not significantly associated with the outcome. There were no significant interaction effects between psychological and biomedical factors. CONCLUSIONS These findings provide evidence that antenatal depression is significantly associated with spontaneous preterm birth in a population of European women receiving early and regular care.
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Baume S, Cheret A, Creveuil C, Vardon D, Herlicoviez M, Dreyfus M. [Complications of vacuum extractor deliveries]. ACTA ACUST UNITED AC 2004; 33:304-11. [PMID: 15170426 DOI: 10.1016/s0368-2315(04)96459-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To describe maternal and neonatal complications following deliveries assisted by vacuum extraction and to compare outcomes with those obtained after spontaneous vaginal delivery. We wanted to know if vacuum extractor was a risk factor by itself. MATERIALS AND METHODS We conducted a retrospective study of two years activity involving 4524 deliveries of which 845 (18.7%) were vacuum extractor assisted. We precisely defined maternal and neonatal complications to compare their rates in spontaneous vaginal delivery and vacuum extractor groups. RESULTS There were 1333 maternal complications and 114 neonatal complications. The adjusted risks of maternal complications were significantly higher in the vacuum extractor group for simple vaginal tears (OR=3.0; p<0.001), the simple perineal tears (OR=1.8; p<0.001) and third degree perineal tears (OR=2.7; p<0.01). For neonatal complications, the difference was significant for cephalhematomas (OR=10; p<0.001) and scalp abrasions (OR=53; p<0.001). No cases of skull fracture or subgaleal subaponeurotic hemorrhage were recorded. CONCLUSION Our rates of maternal and neonatal complications after vacuum extractor were similar to those described in the literature. We have been able to show that vacuum extraction is itself a risk factor for third degree perineal tears and cephalhematoma. However, these complications are so infrequent that the advantages of this method of extraction argue in favor of wide use in obstetrics.
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Vallaeys A, Gournay M, Vasse T, Creveuil C, Regeasse A. La violence externe en milieu hospitalier. ARCH MAL PROF ENVIRO 2004. [DOI: 10.1016/s1775-8785(04)93149-9] [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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